Cervix - Cytology
Inflammation / parasites
Tuberculosis

Author: John Philip, M.D. (see Authors page)
Editor: Ziyan T. Salih, M.D.

Revised: 16 May 2017, last major update July 2015

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: Tuberculosis [title] cervix
Cite this page: Tuberculosis. PathologyOutlines.com website. http://pathologyoutlines.com/topic/cervixcytologytb.html. Accessed June 22nd, 2017.
Terminology
  • Also called Koch disease
Epidemiology
  • Relatively rare in Western countries including the USA but incidence is increasing with AIDS
Sites
  • Most commonly affects the lungs, see topic
  • Genital tuberculosis is usually secondary to pulmonary tuberculosis
  • Within genital tract, most commonly affected organs are fallopian tubes (90%), endometrium (50%), ovary (10 - 30%) (Diagn Cytopathol 2009;37:592)
Etiology
  • Caused mainly by Mycobacterium tuberculosis
Clinical features
  • Menstrual irregularities, infertility, vaginal discharge or pelvic pain
  • Cervical lesions: papillary / vegetative growth or ulceration mimicking cervical cancer (J Cytol 2012;29:86, Acta Cytol 1989;33:305)
Case reports
Treatment
  • Antituberculosis therapy (also termed chemotherapy in this context)
  • Surgery may be needed for large tube ovarian abscess
Cytology description
  • Granulomas consisting of aggregates of epithelioid histiocytes
  • Histiocytes tend to be pink with vesicular and oval nuclei arranged in a syncytium with indistinct cytoplasmic borders
  • Langhans type multinucleated giant cells with 20 - 30 peripherally arranged vesicular nuclei may be seen
  • Variable numbers of lymphocytes are seen
  • Granular amorphous background matrix material indicates caseating necrosis
  • Heavy acute inflammatory exudate may be seen after secondary infection
Cytology images

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Tuberculosis cervicitis

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Epithelioid histiocytes

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Langhans giant cell


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Parabasal cells

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Ziehl Neelson

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Auramine

Positive stains
  • Ziehl-Neelson and auramine-rhodamine (immunofluorescent) stains
Differential diagnosis