Acute endometritis is usually seen postpartum or post-termination due to retained placental tissue or instrumentation. It shows severe neutrophilic infiltrate with microabscess formation in the endometrial glands and stroma. Chronic endometritis occurs as part of pelvic inflammatory disease and is characterised by plasma cell presence in the endometrial tissue. Granulomatous inflammation can be seen in sarcoidosis (noncaseating granulomas), tuberculosis (caseating granulomas with acid-fast bacillus (AFB) positivity). Xanthogranulomatous endometritis is characterised by foamy histiocytes, giant cells and plasma cells is seen in elderly women with pyometra and cervical stenosis. In patients with an intrauterine contraceptive device, actinomyces may be the causative agent.