Incidental granulomatous inflammation of the uterus

BACKGROUND: Granulomas of the uterine corpus have been reported in a variety of pathologic conditions but are relatively rare findings in routine histopathologic material. METHODS: This retrospective clinicopathologic study reviewed patients diagnosed with uterine granulomas between 1980 and 1999 in a tertiary referral center. RESULTS: The study group was comprised of 11 women, ranging in age from 37 to 90 years. All patients had histologically confirmed, non-necrotizing granulomas. The most common symptom prompting biopsy or hysterectomy was abnormal bleeding. Several concomittant histopathologies were noted. Eight of 11 patients had a known history of uterine instrumentation. None of the patients had clinical evidence of sarcoidosis or systemic infection, and stains for microorganisms were negative in all cases. Polarizable or foreign materials were not seen. CONCLUSIONS: Well-formed, non-necrotizing granulomas are an infrequent finding in the uterus. A history of instrumentation may explain the presence of granulomas in a subset of patients.