Problematic Issues Related to the Phenotypic Characteristics, Persistence, and Progression of Chronic Endometritis a Critical Review

Oliko Murghulia, George Tevdorashvili, Nino Tevzadze, George Burkadze
In: Medical Times · 2024 · vol. 2(1) , pp. 35–41 · doi:10.71419/mtggrc.2024.15 · W4407101824
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

This review discusses diagnostic challenges for chronic endometritis, including asymptomatic presentation and nonspecific ultrasound findings, highlighting hysteroscopy and histopathology as key diagnostic tools.

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This critical review describes chronic endometritis as mild persistent inflammation of the endometrium, defined histologically by inflammatory cells in the endometrial stroma, including plasma cells, lymphocytes, and eosinophils, and notes that diagnosis is difficult because many patients are asymptomatic and ultrasound findings are nonspecific. It reviews diagnostic approaches, stating that microbiological testing is often uninformative due to many non-cultivable pathogens, while hysteroscopy may show endometrial changes (e.g., hyperemia, stromal edema, micro polyps) and that histopathologic detection of plasma cells in biopsy specimens is considered the gold standard. The review highlights that opinions differ on how chronic endometritis persists and progresses, and explicitly notes that evidence linking it to endometriosis is very scarce as a limitation/knowledge gap. Relevance to endometriosis: the paper mentions a hypothesis that chronic endometritis may be related to endometriosis, though it is described as supported by very scarce studies, even though the paper’s main focus is chronic endometritis diagnosis and knowledge gaps.

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Abstract

Chronic endometritis is defined as mild persistent inflammation of the endometrium, characterized histologically by inflammatory cells in the endometrial stroma, including plasma cells, lymphocytes, eosinophils, and even lymphoid follicles. Diagnosing chronic endometritis is difficult for a variety of reasons. Most patients are asymptomatic, and ultrasound features are nonspecific. Microbiological examination is often not informative because most pathogens are non-cultivable. A hysteroscopy can diagnose chronic endometritis by detecting specific endometrial changes, such as focal or diffuse hyperemia, stromal edema, and micro polyps. Histopathological identification of plasma cells in endometrial biopsy specimens is considered the gold standard for the diagnosis of chronic endometritis. There is a hypothesis that chronic endometritis may be related to endometriosis, although studies in this direction are very scarce. There are different opinions about the persistence and progression of chronic endometritis, which require further research.
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Problematic Issues Related to the Phenotypic Characteristics, Persistence, and Progression of Chronic Endometritis a Critical Review DOI: https://doi.org/10.71419/mtggrc.2024.15Keywords: chronic endometritis, plasma cellsAbstract Chronic endometritis is defined as mild persistent inflammation of the endometrium, characterized histologically by inflammatory cells in the endometrial stroma, including plasma cells, lymphocytes, eosinophils, and even lymphoid follicles. Diagnosing chronic endometritis is difficult for a variety of reasons. Most patients are asymptomatic, and ultrasound features are nonspecific. Microbiological examination is often not informative because most pathogens are non-cultivable. A hysteroscopy can diagnose chronic endometritis by detecting specific endometrial changes, such as focal or diffuse hyperemia, stromal edema, and micro polyps. Histopathological identification of plasma cells in endometrial biopsy specimens is considered the gold standard for the diagnosis of chronic endometritis. There is a hypothesis that chronic endometritis may be related to endometriosis, although studies in this direction are very scarce. There are different opinions about the persistence and progression of chronic endometritis, which require further research. Downloads Published Issue Section License Copyright (c) 2024 Oliko Murghulia, George Tevdorashvili, Nino Tevzadze, George Burkadze (Author) This work is licensed under a Creative Commons Attribution 4.0 International License. In case an article is accepted for publication it is allowed to combine the article with other research, to conduct new research on the article, or to make different arrangements on condition that the same license is used including commercial purposes. As an author of an article published in the Medical Times, you retain the copyright of your article and you are free to reproduce and disseminate your work.

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