In female genital tuberculosis (FGTB), which structure is MOST commonly affected, and what is the most reliable diagnostic test?

• A Fallopian tube; laparoscopy showing 'tobacco pouch' appearance with histopathology and CBNAAT ✓
• B Endometrium; endometrial biopsy for AFB culture and CBNAAT/PCR
• C Ovaries; laparoscopic biopsy with histopathology for granulomas
• D Cervix; Pap smear showing giant cells and caseation

Explanation

The fallopian tubes are the most commonly involved site in female genital TB (95–100% of cases), followed by the endometrium (50–60%). The characteristic laparoscopic finding is a 'tobacco pouch' or 'violin string' appearance with distorted, thickened, fibrosed tubes, often with peritoneal and omental adhesions. The most reliable diagnostic combination is laparoscopic tissue biopsy with both histopathology (caseous granulomas with Langhans cells) and CBNAAT (GeneXpert) or culture for Mycobacterium tuberculosis. Endometrial sampling (via curettage or Pipelle) is less sensitive but less invasive.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.