Histopathologic Analysis of Female Genital Tuberculosis with Clinical Correlation: A Fifteen Year Study in a Tertiary Hospital of India

Abstract

Background: Tuberculosis remains a global health problem and is an important cause of morbidity and mortality. Female genital tuberculosis (FGTB), though rare in western world, is relevant in developing countries like India.

Aims and Objective: The aim of this study was to determine histologic findings of different parts of female genital tract affected by TB and to correlate it with clinical and other features.

Materials and Methods: A total number of 110 cases of FGTB from 92 patients were included over a period of 15 years. (April, 1997 to March, 2012) The age range of the patients was 17 to 45 years with mean of 26.3 years. The diagnostic procedures used were curettage biopsy, hysterectomy, histologic examination, culture, Mycobacterium tuberculosis-polymerase chain reaction, laparoscopy, hysterosalpingography, and ultrasonography. Patients of FGTB presented with infertility (65-70%), pelvic/ abdominal pain (50-55%), and menstrual disturbances (20-25%).

Results: FGTB involved vulva (2), vagina (1), cervix (5), endometrium (66), fallopian tube (24), and ovaries (12). Out of 66 endometrial TB, proliferative, secretory endometrium, and atrophic endometrium were seen in 53, 09, and 04 cases. HIV co-infection was found only in 5 cases, and acid-fast bacilli in tissue sections were detected in 7 cases.

Conclusions: FGTB is not uncommon in developing countries and is an important cause of infertility. Though fallopian tube was the most common site in many studies, in this study, endometrium emerges as the commonest site.

Keywords: Female genital tuberculosis, histopathology, HIV