Presentation of endometrial vascular dystrophy under narrow-band imaging: Two case reports and literature review.

Rationale: Endometrial vascular dystrophy is a rare and poorly understood pathological condition characterized by tortuous and dilated blood vessels visible under hysteroscopy. Diagnosing this condition is challenging due to its potential resemblance to more severe lesions, such as endometrial hyperplasia or carcinoma. Narrow-band imaging (NBI) technology enhances the visualization of superficial vascular structures, offering a new perspective for diagnosis. This study aims to explore the application value of NBI technology in identifying endometrial vascular abnormalities, thereby improving diagnostic accuracy and differentiating this condition from more serious pathologies.

Patient Concerns: Case 1 is a 32-year-old woman presenting with vaginal bleeding for 8 days and a history of intermittent bleeding for 2 months. Case 2 is a 47-year-old woman with increased menstrual flow and prolonged periods for the past 2 months. Hysteroscopy revealed endometrial vascular dystrophy in both cases, with the presence of endometrial polyps.

Diagnoses: Both patients were diagnosed with endometrial vascular dystrophy and endometrial polyps.

Interventions: Hysteroscopy in both cases revealed a multitude of curved and dilated cord-like capillary loops, along with endometrial polyps. Targeted biopsies and polyp excision were performed.

Outcomes: Both patients received levonorgestrel-releasing intrauterine system treatment and showed symptom improvement at 6-month follow-up. Pathology confirmed endometrial polyps and secretory phase endometrium, with no malignancy.

Lessons: This study emphasizes the importance of NBI technology in identifying and diagnosing endometrial vascular dystrophy and its associated conditions, such as endometrial polyps. NBI provides clearer vascular imaging, aiding in precise targeted biopsies, thereby enhancing diagnostic accuracy and therapeutic efficacy. This research highlights the potential of NBI as a valuable tool in gynecological endoscopy for the diagnosis of rare endometrial conditions.