Histopathologic analysis of female genital tuberculosis: a fifteen-year retrospective study of 110 cases in eastern india

Santosh Kumar Mondal

doi:10.5146/tjpath.2013.01146

Abstract

Tuberculosis remains a global health problem and is an important cause of morbidity and mortality. Female genital tuberculosis is rare in the western world, but relevant in developing countries like India. The aim of this study was to determine histologic findings of different parts of the female genital tract affected by tuberculosis and to correlate it with other features. A total number of 110 cases of female genital tuberculosis from 92 patients were included over a period of 15 years. The age range of the patients was 17 to 45 years with a mean of 26.3. The diagnostic procedures used were curettage biopsy, hysterectomy, histologic examination, culture, Mycobacterium Tuberculosispolymerase chain reaction, laparoscopy, hysterosalpingography and ultrasonography. Patients with female genital tuberculosis presented with infertility (65-70%), pelvic/ abdominal pain (50-55%) and menstrual disturbances (20-25%). Female genital tuberculosis involved the vulva (2), vagina (1), cervix (5), endometrium (66), fallopian tube (24) and ovaries (12). Out of 66 endometrial tuberculosis cases, proliferative, secretory endometrium and atrophic endometrium were seen in 53, 9, and 4 cases, respectively. HIV co-infection was found only in 5 cases and acid-fast bacilli in tissue sections were detected in 7 cases. Female genital tuberculosis is not uncommon in developing countries and is an important cause of infertility. Though the fallopian tube was the most common site in many studies, the endometrium was the commonest site in this study.

Highlights

Morgagni first described genital tuberculosis in the mid eighteenth century and the tuberculous bacillus was discovered in 1882 by Koch [1]
Patients with female genital tuberculosis presented with infertility (65-70%), pelvic/ abdominal pain (50-55%) and menstrual disturbances (20-25%)
Though the fallopian tube was the most common site in many studies, the endometrium was the commonest site in this study

Summary

Introduction

Morgagni first described genital tuberculosis in the mid eighteenth century and the tuberculous bacillus was discovered in 1882 by Koch [1]. Tuberculosis is the second most common cause of death worldwide amongst communicable diseases. It kills nearly 2 million people each year and developing countries are mostly affected [2]. Genital tuberculosis in females occurs secondary to (Turk Patoloji Derg 2013, 29:41-45). Mondal S K: Female Genital Tuberculosis primary disease in the lung, lymph nodes, urinary tract, bones, joints, and bowel. The spread is usually by the hematogenous or lymphatic route. Sexual transmission of female genital tuberculosis (FGTB) has been reported but direct spread from other intraperitoneal foci is very rare

Results

Discussion

Conclusion