A 29-year-old nulliparous woman presents with postcoital bleeding and a hypertrophic, ulceroproliferative-looking cervix. Cervical biopsy shows epithelioid cell granulomas with central caseation and Langhans giant cells; acid-fast staining and mycobacterial culture confirm tuberculosis. The MOST likely explanation for this appearance is:

• A Cervical endometriosis
• B Metastatic endometrial carcinoma seeding the cervix
• C Chronic cervicitis with squamous metaplasia
• D Tuberculous cervicitis simulating carcinoma of the cervix ✓

Explanation

Cervical tuberculosis is uncommon but classically produces a hypertrophic, papillary, or ulcerative lesion that bleeds on touch and grossly mimics carcinoma, especially in young women where true cervical cancer is rare. Histology showing caseating granulomas with Langhans giant cells confirms the diagnosis. Squamous metaplasia and endometriosis do not produce granulomas, and metastatic carcinoma would show malignant epithelial cells rather than caseation.

Reference: Shaw's Textbook of Gynaecology, 18th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.