Histopathologic patterns of female genital tuberculosis with clinical correlation: a 10-year (2013-2022) retrospective cross-sectional study

• Published in: BMC women's health Vol. 24; no. 1; pp. 370 - 10
• Main Authors: Melkamu, Kidest, Damie, Amanuel, Ashenafi, Senait, Sori, Moti, Girma, Selfu, Yimam, Sofia, Baye, Negash, Shote, Belachew
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 26.06.2024; BioMed Central; BMC
• Subjects: Abdomen; Abdominal Pain - etiology; Adolescent; Adult; Analysis; Archives & records; Asymptomatic; Biopsy; Care and treatment; Cervix Uteri - microbiology; Cervix Uteri - pathology; Coronaviruses; Cross-Sectional Studies; Demographic aspects; Diagnosis; Endometritis - diagnosis; Endometritis - microbiology; Endometritis - pathology; Endometrium - microbiology; Endometrium - pathology; Ethiopia - epidemiology; Extrapulmonary; Fallopian Tubes - microbiology; Fallopian Tubes - pathology; Female; Female genital; Females; Granulomas; Gynecology; Histology, Pathological; Histopathology; HIV; Human immunodeficiency virus; Humans; Hysterectomy; Infertility; Infertility, Female; Infertility, Female - etiology; Laparotomy; Medical screening; Menstruation; Menstruation Disturbances - pathology; Middle Aged; Morbidity; Mortality; Oophorectomy; Ovaries; Ovary - pathology; Pain; Pelvic Pain - etiology; Pregnancy complications; Prevention; Retrospective Studies; Risk factors; Sexual disorders; Tuberculosis; Tuberculosis, Female Genital - complications; Tuberculosis, Female Genital - diagnosis; Tuberculosis, Female Genital - pathology; Vulva - microbiology; Vulva - pathology; Womens health; Young Adult; Ethiopia; Tuberculosis; Extrapulmonary; Infertility; Female genital
• ISSN: 1472-6874; 1472-6874
• DOI: 10.1186/s12905-024-03207-8

Underdiagnosis of female genital tuberculosis (FGTB) often leads to infertility. In this study, we aimed to determine the site and histopathologic patterns of FGTB and its correlation with clinical presentation and acid-fast bacilli (AFB) status. A retrospective cross-sectional study was conducted on 122 patients with a histopathological diagnosis of FGTB at the Department of Pathology, College of Health Sciences (CHS), Tikur Anbessa Specialized Hospital (TASH), Addis Ababa University (AAU), from January 1, 2013, to August 30, 2022. Female genital tuberculosis was found in 0.94% of the gynecology specimens examined. The most common presentations were menstrual disturbance, abdominopelvic pain, and infertility. Among patients with FGTB, 4.6% exhibited misleading clinical and radiologic findings, leading to suspicion of malignancy and subsequent aggressive surgical management. The endometrium was the most frequently affected organ, followed by the fallopian tube, ovary, cervix, and vulva. In the majority of tuberculous endometritis cases (53.3%), histopathology revealed early-stage granulomas. Acid-fast bacilli were found in a significant proportion (42.6%) of FGTB tissues with TB histopathology. The ovary had the highest rate of AFB detection, followed by the fallopian tube, endometrium, and cervix. Female genital tuberculosis should be considered in reproductive-age women presenting with menstrual irregularities, abdominopelvic pain, infertility, or an abdominopelvic mass. The endometrium is commonly affected, displaying early granulomas with low AFB positivity.