Tuberculosis in Pap samples with emphasis on LBC: Caught only when thought

Abstract

Despite being a commonly encountered infection, the clinical diagnosis of tuberculosis of the uterine cervix is elusive. Though a straightforward diagnosis on tissue sections, identification of typical features of tubercular infection on cervical Pap samples is challenging. In our experience, the infrequent pale staining collections of epithelioid cells are difficult to pick up on Pap stained smears, particularly LBC samples. In this series, 2 of the three samples were reported as atypical squamous cells of undetermined significance while 1 was reported as inflammatory at the initial diagnosis. Scattered Langhans' type giant cells may be seen as a subtle clue which should prompt the search for epithelioid cell granulomas. These cases may have a mass lesion clinically while no obvious signs of malignancy on the cervical samples.

Cytological diagnosis of cervical tuberculosis in a woman with cervical growth

“…This highlights the need to increase the awareness about the identification of granulomas in cervical Papanicolaou smears. Ziehl‐Neelsen staining on these smears may reveal the presence of acid‐fast bacilli and help in confirming the diagnosis (Figure ) …”