Vulval lymphangiectasia secondary to tubercular lymphadenitis

Abstract

A 25-year-old married woman presented with swelling of vulva with oozing of watery fluid from vulval skin surface for the past 8 years. She also complained of swelling in the inguinal region (occasionally painful) on both sides for the past 8 years. Local genital examination revealed diffuse indurated swelling of the labia majora with overlying skin studded with papulo-vesicles and oozing of milky fluid. Nontender, firm, matted lymph nodes involving both horizontal and vertical groups of inguinal lymph nodes were found bilaterally. Histopathology of the lesion was consistent with lymphangiectasia. Fine needle aspiration cytology from the right inguinal lymph node showed caseating epitheliod cell granulomas with calcification consistent with tuberculosis. Acid-fast bacilli and parasites were not seen. Hemogram was normal except for raised erythrocyte sedimentation rate (35 mm in the first hour). Mantoux test was highly reactive (15 × 15 mm). A final diagnosis of lymphangiectasia of the vulva secondary to tubercular lymphadenitis was made. The patient was started on anti-tubercular drug therapy. There was a partial recovery in the genital lesions.