内膜細胞診で診断しえた結核性腹膜炎の１例

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  • A case of pelvic tuberculosis diagnosed by endometrial cytology

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Background: We report a case of female genital tract and pelvic tuberculosis with an adnexal mass requiring differentiation from ovarian carcinoma.<BR>Case: A 53-year-old woman with lower abdominal and coital pain was found in clinical and radiological examination to have a bilateral adnexal mass with ascites, suggestive of ovarian carcinoma. Endometrial cytology showed both epitheloid cells and Langhans-type giant cells against a background of lymphocytes. Endometrial histology showed granulomatous endometritis. Culturing for M. tuberculosis for uterine cervical and endometrial mucus were positive. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were done. Histology showed granulomatous inflammation involving the peritoneum, salpinx, and endometrium. The patient treated with refampicin and isoniazid for 6 months and remained well without recurrence of signs such as ascites.<BR>Conclusion: Clinicians should consider female genital tract and pelvic tuberculosis as a differential diagnosis when encountering the clinical presentation of a pelvic mass and ascites.

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