A 28-year-old woman with primary infertility and amenorrhoea undergoes hysteroscopy which shows a hypoplastic uterine cavity with pale adhesions and absent endometrium. Endometrial biopsy shows epithelioid granulomas with Langhans giant cells and caseous necrosis. PCR for Mycobacterium tuberculosis is positive. This is genital TB. Which of the following is the most common site of genital TB in India?
- A Endometrium
- B Ovaries
- C Fallopian tubes ✓
- D Cervix
Explanation
In genital tuberculosis, the fallopian tubes are the primary and most commonly affected site (90–100% of cases of genital TB), as haematogenous spread from a pulmonary or gastrointestinal primary focus seeds the tubes first. From the tubes, the infection spreads contiguously to the endometrium (50–80%), ovaries (20–30%), and rarely to the cervix (5–15%) and vagina (<1%). The characteristic finding is 'tobacco pouch' appearance of bilateral tubal fimbriae. The endometrium is the second most common site, and the clinical presentation with Asherman's-like changes reflects endometrial destruction by tuberculous granulomas.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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