3–10% of endometrial biopsies are said to show histologic evidence of chronic endometritis. In this study we correlate the # of plasma cells by H&E to the # of plasma cells by CD138 IHC in endometrial biopsies.Methods100 endometrial biopsies were selected, excluding specimens with limited material, cancer and menstrual phase. H&Es were reviewed, and the # of plasma cells/10 hpfs were recorded. Additional sections were stained with CD138 antibody (clone B‐A38; Cell Marque, Rocklin, CA). Hot spots of CD138+ cells were recorded as the #/10 hpfs. Histologic findings near the CD138+ cells were also recorded.ResultsPlasma cells were identified in 29 cases by H&E alone (ave. 2.1, range 1–12) and 90 cases were + for plasma cells by CD138 (ave. 13.9 plasma cells, range 1–190). Of the 29 cases with plasma cells on H&E, CD138 highlighted an average of 24.3, with a minimum of 1. 71 biopsies lacked plasma cells on initial H&E review, but averaged 7.7 plasma cells by CD138. Often, the endometrial stroma contains scattered lymphocytes or mild edema, but lacked the spindled stroma typically associated with chronic endometritis.ConclusionsBy careful exam on H&E, >1 plasma cells were seen in 29% vs. 90% of endometrial bxs by CD138. These cases include diagnoses of gland‐stromal dyssynchrony, disordered proliferative endometria, and endometrial hyperplasias. The presence of CD138+ plasma cells may not equate to chronic endometritis.
Chronic endometritis is commonly diagnosed by identification of plasma cells that may be difficult to distinguish from stromal cells or lymphocytes. We correlate the concurrent presence of eosinophils and plasma cells by H&E and CD138 stains in endometrial biopsies.Methods100 consecutive endometrial biopsies were examined for eosinophils and plasma cells. Cases were stained with anti‐CD138 (mouse monoclonal, clone B‐A38; Cell Marque, Rocklin, CA). H&E and CD138 slides were reviewed, and the number of plasma cells and eosinophils/10 hpfs were recorded. The numbers of plasma cells and eosinophils were recorded again after re‐review of H&Es in areas with high numbers of CD138+ cells.Results90/100 cases were + for plasma cells by CD138. 57% of the CD138 immunostained subset contained eosinophils by H&E. Utilizing the CD138 stain to map the area of positivity, eosinophils were identified in the area as the plasma cells in 92% of cases and ranged from 1–61/10 hpf. Of the 10 cases lacking plasma cells by CD138, eosinophils were present in 10%.ConclusionEosinophils are a surrogate marker for the presence of plasma cells in endometrial biopsies. However, plasma cells are more frequently found than eosinophils: 52% contain eosinophils and 90% contain plasma cells. Both may be present as a result of a variety of inflammatory states and are often seen. Clinical correlation is critical for diagnosis of chronic endometritis.
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