Tubal Tuberculosis Research Articles

Crucial computed tomography and magnetic resonance imaging findings of fallopian tubal tuberculosis for diagnosis: a retrospective study of 26 cases.

Fallopian tubal tuberculosis (FTTB), which typically presents with non-specific clinical symptoms and mimics ovarian malignancies clinically and radiologically, often affects young reproductive females and can lead to infertility if not promptly managed. Early diagnosis by imaging modalities is crucial for initiating timely anti-tuberculosis (anti-TB) treatment. Currently, comprehensive radiological descriptions of this relatively rare disease are limited. We aimed to comprehensively investigate the computed tomography (CT) and magnetic resonance imaging (MRI) characteristics of FTTB in patients from the Kashi area, which has the highest incidence of TB in China, to extend radiologists' understanding of this disease. We conducted a retrospective cross-sectional study of 26 patients diagnosed with FTTB at the First People's Hospital of Kashi Area. All the patients underwent abdominal and pelvic contrast-enhanced CT examinations and/or pelvic contrast-enhanced MRI from January 2017 to June 2022. The imaging findings were evaluated in consensus by two experienced radiologists specialized in abdominal and pelvic imaging. The evaluated sites included the fallopian tubes, ovaries, peritoneum, mesentery, retroperitoneal nodes, and parailiac nodes. The patient characteristics are reported using descriptive statistics. The patient imaging results are presented as percentages. The normally distributed continuous variables are reported as the mean ± standard deviation (SD), and otherwise as the median with the interquartile range (IQR). The median age of the patients was 27 years (IQR: 25-34 years). Bilateral involvement of the fallopian tubes was observed in all patients. The tubal wall appeared coarse with tiny intraductal nodules in 96% (25 of 26) of the patients. The mean CT value of the tubal contents was 34 Hounsfield units (HUs; SD: 3.3 HUs). Ascites was present in 92% (24 of 26) of the patients, with 20 patients showing encapsulated effusion. Among these patients, 20 exhibited the highest CT values of ascites (>20 HUs). Linear enhancement of the parietal peritoneum was observed in 88% (23 of 26) of the patients, of whom 22 had peritoneal nodules measuring a median diameter of 0.4 cm (IQR: 0.3-0.6 cm). Eight patients had retroperitoneal and parailiac nodal enlargement, of whom two showed nodal necrosis, and none displayed nodal calcification. FTTB is consistently accompanied by tuberculous peritonitis. FTTB typically presents with tubal dilation, and coarseness and nodules in the lumen, as well as intraductal caseous material and calcification. Tuberculous peritonitis exhibits high-density ascites, peritoneal adhesion, linear enhancement of the parietal peritoneum, and tiny peritoneal nodules. The co-occurrence of these features strongly suggests a diagnosis of FTTB.

Study on the relationship between CXCR3 and its ligands and tubal tuberculosis

ObjectiveChemokines play an important role in Mycobacterium tuberculosis infection. We aimed to investigate CXCR3, CXCL9, CXCL10 and CXCL11 to explore the correlation between the severity of tubal tuberculosis and chemokines. Methods26 patients with tubal tuberculosis diagnosed in our hospital from 2016 to 2019 were selected as the experimental group, and 18 female patients who underwent high-risk pregnancy supervision in our hospital from 2016 to 2018 were selected as the control group. The pathological manifestations of tubal tuberculosis were observed by HE staining, the expressions of CXCR3 and its ligands in fallopian tubes were detected by immunohistochemistry. ResultsTypical granulomatous structure of tubal tuberculosis was observed by HE staining and most of them were accompanied by massive necrosis in the experimental group, while no granulomatous lesions were found in the control group. The results of immunohistochemical staining showed that CXCR3 and its ligands were expressed in the cytoplasm and nucleus of oviduct epithelial cells and inflammatory cells, in the granuloma area. CXCL9, CXCL10 and CXCL11 were related to the severity of the disease. Key findingsCXCR3 and its ligands were positively expressed in tubal tuberculosis, especially CXCL9, CXCL10 and CXCL11 were positively correlated with the severity of fallopian tube disease. SignificanceIt is helpful for clinical diagnosis and treatment detection, and provides a new therapeutic target for the study of female genital tuberculosis in the future.

In vitro fertilization outcome in women with endometrial tuberculosis and tubal tuberculosis

Purpose: To evaluate in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) outcome in women with genital tuberculosis (GTB).Methods: One hundred and fifty-five women with genital tuberculosis constituted the study group (Group A), consisting of 25 patients with endometrial tuberculosis (Group A1) and 130 patients with tubal tuberculosis (Group A2). Women with non-tuberculous tubal infertility were matched by age and study period served as controls (Group B).Results: Patients with GTB had significantly reduced endometrial thickness, high-quality embryos rate, implantation rate as compared with controls (p < .05), no differences were found in other pregnancy parameters. In addition, the endometrial thickness, fertilization rate, high-quality embryos rate and implantation rate were also significantly lower in women with endometrial tuberculosis as compared with controls. And the cumulative pregnancy rate in endometrial tuberculosis was significantly decreased compared with tubal tuberculosis and controls (p < .05). However, IVF/ICSI pregnancy outcomes in patients with tubal tuberculosis showed no difference as compared with controls (p > .05). Also, rates of miscarriage, preterm birth, obstetrical complications, and neonatal problems did not differ among three groups.Conclusions: In conclusion, IVF/ICSI-ET remains the most optimal method for the treatment of female infertility associated with tubal tuberculosis. However, patients with endometrium tuberculosis showed significantly reduced fertilization, implantation and cumulative pregnancy rates.

English

Primary fallopian tube carcinoma [PFTC] is an uncommon, aggressive neoplasm. Diagnosis is based on ultrasonographic findings combined with a thorough histopathological examination. It must be considered as a differential diagnosis in patients presenting with vaginal bleed or discharge, with bilateral adnexal masses and those who fail to respond to antibiotic therapy and drainage. Tubal tuberculosis and trauma have been considered by some to be carcinogenic factors inducing multifocal tumorigenesis of the mullerian duct. Fallopian tube carcinoma being included as part of the cancer spectrum associated with inherited BRCA mutations. We present here a rare case report of a 49yr old lady who came with complains of white discharge per vagina of 6 months duration and underwent bilateral salpingo-oophorectomy, in view of nodular echogenic lesions in the bilateral adnexa on ultrasonography. A diagnosis of primary serous adenocarcinoma - FIGO Stage IC was rendered after histopathological examination. It is important to note that metastasis to the tube is often bilateral in majority of the cases. Primary uterine and ovarian malignancies need to be excluded as in the present case.

Bilateral tubal tuberculosis as a cause of chronic pelvic pain and sterility

A 29-year-old woman presented with a 12-month history of subfebrile chronic pelvic pain. Prior to this she had no previous medical history of pelvic inflammatory disease. On gynecological examination, bilateral adnexal masses were palpable. Ultrasonographically, bilateral adnexal masses 8×6 cm were visible with different echogenicity, and the Douglas space was totally filled with masses. On power Doppler examination, blood flow was detected bilaterally through the masses with a resistive index of 0.42. Neither ovary was visible. Laparoscopically we found bilateral tubal tuberculosis with no other pathology. Bilateral salpingectomy was undertaken. After surgery the patient received tuberculostatic therapy for 6 months.

Diagnosis of Female Genital Tuberculosis by Means of Hysterosalpingography. Especially on the Clinico-Pathological Figures and Progress of Such Disease

Since methods for successful cultivation of tubercle bacilli from genital organs were established more than a dozen years ago (Shinoda & Iwabuchi5), 1941; Furuhashis6), 1947; Halbrecht7), 1947; Yamaguchi8), 1952), studies on genital tuberculosis have been encouraged and minute schedules of classification of tuberculous findings based on HSG have been undertaken by Shinoda & Takahashi2) (1943), Kika, Yamaguchi, et al.9-12) (1951) in Japan and noteworthy reports on the subjects have appeared in Europe too, of Magnusson14) (1945, 1947), Rozin3) (1952, 1954), Ekengren & Ryden4) (1952) and some others15)16)17). On the correlation, however, between the different types of tuberculous HSG shadows, their combination and the relation of the findings to discharge of tubercle bacilli we have no report available to date. We have once discussed the pathological pictures and development of genital tuberculosis classifying the cases with the disease into three groups with consideration to the results of cultivation of tubercle bacilli and endometrial biopsy (Kika, Yamaguchi, et al.9), 1952) and in the present paper, have described the existence of Type A and B among the representative types of tubal findings on HSG, discovered in our closer examination of the HSG of tuberculous cases. From considerations on some relavant findings, we are led to conclude that the Type A findings are younger than the Type B findings and it seems the former develops eventually into the latter. The fundamental type of uterine findings was inferred to consist in the tiny serrations in the uterine walls, which first arise in the fundus near the uterine cornu and gradually spread all over the uterine wall. These has been no report on the development of genital tuberculosis studied from the angle of HSG findings, except that by Ekengren & Ryden4) (1950) on the progress of tubal tuberculosis. Their results are in rather good agreement with the ours, but we must state with regret that they failed to study the subject from the bacteriological angle and to review the results in comprehensive discussion with the uterine and the pelvic roentgenographic findings. Our study, we hope, my serve in supplementing some of the shortcomings of their studies.

Tubal tuberculosis and pregnancy.

Tubal tuberculosis and pregnancy.

X-ray picture of uterine and tubal tuberculosis: Marsalek, J.: Gynaecologia 135: 37, 1953

X-ray picture of uterine and tubal tuberculosis: Marsalek, J.: Gynaecologia 135: 37, 1953

The X-ray Picture of Uterine and Tubal Tuberculosis

The X-ray Picture of Uterine and Tubal Tuberculosis

Tubal pregnancy associated with tubal tuberculosis

A case of tubal pregnancy associated with tuberculous salpingitis is reported.The remarkable fetal development through a five to six months' period probably resulted from previous tuberculous thickening of the tube wall, preventing earlier rupture.

Tubal pregnancy associated with tubal tuberculosis

Tubal pregnancy associated with tubal tuberculosis

Diagnosis of Tubal and Peritoneal Tuberculosis

Diagnosis of Tubal and Peritoneal Tuberculosis