Fallopian tube: Fallopian tubes are involved in almost all women in genital TB, and the involvement is usually bilateral. The fallopian tubes are likely the initial source of infection. The tubes start showing changes as progression occurs.
Thickened, enlarged, and tortuous
Collection of the cheesy material in the lumen with blockade of both ends of fallopian tubes due to fibrosis.
Granulomatous lesion with chronic inflammatory infiltrate with or without caseation may be seen in the tube.
Fimbrial processes become greatly swollen.
Adenomatous proliferation of the lining epithelium.
Diagnosis of fallopian TB there is nodular thickening of the tube due to proliferation of tubal epithelium within the hypertrophied muscle layer.
Endometrium: In genital TB, there is a high incidence of involvement of the endometrium. When extensive involvement of the endometrium occurs, there may be ulcerative, granular, or fungating lesions present. Endometrial atrophy also seen. Diagnosis of endometrium TB is the presence of a focal collection of lymphocytes with or without the presence of dilated glands and destruction of the epithelium.
Ovaries: Ovarian involvement occurs in 10–15% cases. There may be tubercles on the ovaries, adhesions, caseation, and tubo-ovarian cyst or mass formation. Two forms of ovarian TB are
Perioophoritis: The extension of lesion from the periphery toward the center. There may be tubercles on the ovaries, adhesions caseation.
Oophoritis: Follow haematogenous spread. Presence of larger foci with caseous centers.
Cervix: The cervix appears to be involved in 5–25% of cases. Presence of velvety and polypoidal growth or ulceration
Vagina and Vulva: Their involvement is rare (1–2%) and is usually secondary to the extension from endometrium or cervix. The disease may be acquired from the male partner with infected seminal vesicles. In Vaginal and vulva TB Irregular ragged ulcer, sometimes with sinuses discharging caseous material and pus is seen.