Geremew Teketel Tadesse, Zewdie Woldie Jember, Seid Noh Abidirkadir, Gutema Tigist
Department of Pathology, Hawassa University Comprehensive Specialized Hospital, Hawassa, Sidama, Ethiopia.
Department of Pathology, Worabe Comprehensive Specialized Hospital, Ethiopia.
Int J Surg Case Rep. 2025 Jan;126:110693. doi: 10.1016/j.ijscr.2024.110693. Epub 2024 Nov 29.
Cervical tuberculosis is an uncommon condition which accounts for 0.1-0.65 % of all cases of tuberculosis (TB). In women with genital TB, four major presenting complaints are described with varying frequencies: infertility, abnormal bleeding, pelvic pain, and amenorrhea. As with other parts of the female genital tract; there are no macroscopic changes in the cervix that are specific for TB. The diagnosis of TB is based on the identification of M. tuberculosis. The treatment of tuberculosis of the cervix is essentially based on antibacillary bactericidal drugs and surgical management based on indication. This case is important because there are few case reports in the world, and it is among the few case to be reported from Ethiopia.
Here we present a 45-year-old female patient presented with odorless whitish vaginal discharge and pelvic pain, she was diagnosed with cervical cancer clinically but histomorphologic examination confirms the diagnosis of primary uterine cervix tuberculosis.
TB is a bacterial infection frequently seen in less developed countries. It is a frequent cause of chronic pelvic inflammation and infertility. Tuberculosis of the cervix may occur as a primary infection or secondary (in which case the primary focus would have healed). Approximately one third of cases are culture negative. Therefore, the presence of typical granulomata is sufficient for diagnosis if other causes of granulomatous cervicitis are excluded or a primary focus identified.
Uterine cervix is an uncommon genital location for tuberculosis. There are no macroscopic changes in the cervix that are specific for TB and it can mimic cervical cancer clinically. A definitive diagnosis of TB requires isolation of tubercle bacilli. It should be considered as a differential diagnosis in patients presenting with non-specific lower genital tract complaints. Close collaborations between clinicians and diagnosticians is essential in accurately diagnosing and managing this rare condition.
宫颈结核是一种罕见疾病，占所有结核病病例的0.1 - 0.65%。在患有生殖器结核的女性中，有四种主要的临床表现，其出现频率各不相同：不孕、异常出血、盆腔疼痛和闭经。与女性生殖道的其他部位一样，宫颈没有特异性的肉眼可见的结核病变。结核病的诊断基于结核分枝杆菌的鉴定。宫颈结核的治疗主要基于抗细菌杀菌药物，并根据指征进行手术管理。该病例很重要，因为世界上此类病例报告很少，且是埃塞俄比亚报告的少数病例之一。
在此，我们介绍一名45岁女性患者，她出现无异味的白色阴道分泌物和盆腔疼痛，临床诊断为宫颈癌，但组织形态学检查确诊为原发性子宫颈结核。
结核病是一种在欠发达国家常见的细菌感染。它是慢性盆腔炎和不孕的常见原因。宫颈结核可能作为原发性感染发生，也可能是继发性的（在这种情况下，原发性病灶可能已经愈合）。大约三分之一的病例培养结果为阴性。因此，如果排除了其他引起肉芽肿性宫颈炎的原因或确定了原发性病灶，典型肉芽肿的存在就足以确诊。
子宫颈是结核病在生殖器部位的罕见发病部位。宫颈没有特异性的肉眼可见的结核病变，临床上可能会误诊为宫颈癌。结核病的确切诊断需要分离出结核杆菌。对于出现非特异性下生殖道症状的患者，应将其视为鉴别诊断之一。临床医生和诊断医生之间的密切合作对于准确诊断和管理这种罕见疾病至关重要。
