In a woman with suspected endometrial tuberculosis who is having regular cycles, endometrial biopsy for histopathological examination gives the HIGHEST diagnostic yield when performed at which point in the cycle?

• A Early proliferative phase, day 5 to 7
• B Premenstrual phase, just before the expected menses ✓
• C During active menstrual flow
• D Mid-secretory phase, day 21 to 22

Explanation

Tuberculous endometritis involves mainly the superficial functional layer, so the highest yield comes from sampling in the late secretory or premenstrual phase, when the thickened functional endometrium contains maximal tubercles before they are shed with menstruation. Biopsy during actual menstrual flow is avoided because tissue is being lost and interpretation is difficult. Sampling the thin early proliferative endometrium misses the superficially seated lesions.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.