case_images: PMC10864011_01
case_images: Transvaginal ultrasound, sagittal scan of the uterus. The endometrial cavity and cervical canal distended by anechoic endocavitary fluid collection with a maximum thickness of 26 mm (yellow line), clear thickened heterogeneous irregular endometrium of 7.8 mm, due to imbibition of the endometrial layer (white markers).
case_images: cureus-0016-00000052268-i01.jpg
case_images: PMC10864011_01_cureus-0016-00000052268-i01.jpg
case_images: FIG1
case_images: On this occasion, the ultrasound scan revealed the presence of an endocavitary fluid collection distending the endometrial cavity and cervical canal, with a maximum breadth of 26 mm and a clear heterogeneous thickened endometrium of 7.8 mm (Figure 1).
case_images: 2D Transvaginal ultrasound sagittal (A) and axial (B) images of the uterus: endocavitary fluid collection with a maximum thickness of 10 mm (red line); hypoechoic endometrium (yellow line), irregular junctional zone, inhomogeneous myometrium with inner hyperechoic layer (green line); total breadth of the uterus affected by the inflammation process with imbibition of the endometrial tissue of 23 mm (yellow line). (C) 3D sagittal, axial, and coronal ultrasound scans: endocavitary fluid collection; inhomogeneous hypoechoic endometrial lining, inhomogeneous myometrium with hyperechoic inner myometrial. (D) 3D ultrasound in axial scan set on TUI mode, which simultaneously displays multiple slices of a volume data set: endocavitary fluid collection; hypoechoic endometrium, irregular junctional zone, inhomogeneous myometrium with inner hyperechoic layer.. TUI, tomographic ultrasound imaging
case_images: cureus-0016-00000052268-i02.jpg
case_images: PMC10864011_01_cureus-0016-00000052268-i02.jpg
case_images: FIG2
case_images: During the recovery, the ultrasound exam, using GE Healthcare Voluson S10, revealed a reduction in the size of the endocavitary fluid, a thickened hypoechoic endometrium, and a hyperechoic inner myometrium (Figure 2).
case_images: (A) Histological photomicrograph showing a biopsy of endometrial tissue with polymorphous elements (hematoxylin-eosin, original magnification 2x). (B) Histological photomicrograph showing histiocytic elements with abundant granular cytoplasm and basophilic inclusions (hematoxylin-eosin, original magnification 20x). (C) Scanning magnification of the previous picture shows the rich histiocytic component (an example is indicated by a black circle) intermingled between the tissue (hematoxylin-eosin, original magnification 40x). (D) Another picture in which eosinophils and macrophages predominate (hematoxylin-eosin, original magnification 40x).
case_images: cureus-0016-00000052268-i03.jpg
case_images: PMC10864011_01_cureus-0016-00000052268-i03.jpg
case_images: FIG3
case_images: The histological examination revealed the presence of infiltration of histiocytic elements with abundant granular cytoplasm and basophilic inclusions (so-called von-Hansemann cells), with accompanying polymorphous cells such as eosinophils, lymphocytes, plasma cells, and rare neutrophils (Figure 3).
case_images: Transvaginal ultrasound sagittal scan of the uterus: thin linear homogeneous hyperechoic endometrium of 1.6 mm; regular homogeneous hypoechoic myometrium. Absence of endocavitary fluid.
case_images: cureus-0016-00000052268-i04.jpg
case_images: PMC10864011_01_cureus-0016-00000052268-i04.jpg
case_images: FIG4