Introduction: Granulomatous lesions in the female genital tract are exceedingly uncommon and can involve multiple sites, fallopian tube being the most frequently affected site followed by endometrium, ovary, cervix, vagina, vulva. These granulomas arise from a range of infectious and non-infectious causes and exhibit diverse morphological patterns varying from confluent granulomas with caseous necrosis, notably in tuberculosis to well-circumscribed non-necrotizing granulomas as seen in sarcoidosis and localized endometrial granulomas in response to previous ablation or diffuse granuloma in systemic disease/infections.
Objectives: This study aimed to analyse and report the clinico-pathological characteristics of granulomatous lesions affecting the female genital tract.
Case reports: We retrospectively analysed five cases of granulomatous diseases involving female genital tract. These cases were reported in the department of Pathology over a period of one year and included two cases of granulomatous salpingitis, two cases of endometrial granulomas and one case of myometrial granuloma. Majority of cases were of tubercular etiology but had varied clinical presentation highlighting the clinical dilemma and diagnostic challenges. Age in our study group ranged from 15 to 40 years. Diffuse granulomas were noted in all cases with caseous necrosis in 3 of them. Additional histopathological findings included presence of foreign body type, Langhans type giant cells, fibrinoid palisading granuloma.
Conclusion: Effective etiological resolution requires integrative assessment combing the histopathological findings with clinical data (age, reproductive status), biochemical, radiological and microbiological evidence (PCR/GeneXpert). Such an integrated approach is essential for accurate diagnosis and appropriate patient management because of the rarity of the disease.
International Journal of Clinical Obstetrics and Gynaecology
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