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Tuberculosis (fallopian tube)

Radswiki et al.

Tuberculosis of the fallopian tube is one of the most common sites of tuberculous pelvic
inflammatory disease.

Clinical presentation

Many patients may be asymptomatic, with the disease being discovered during the workup
for infertility. Signs and symptoms are often vague and can include acute or chronic pain,
infertility, and vaginal bleeding.

Pathology

Like pelvic tuberculosis, infection almost always results from spread from an extragenital
source, usually haematogenous or less commonly via lymphatic vessels or from the
peritoneal cavity.

Distribution

Both tubes are usually affected.

Radiographic features

Plain radiograph

May show calcification of the fallopian tubes in a small proportion of patients.

Tubal calcification can take the form of linear streaks, which lie in the course of the fallopian
tube or appear as faint or dense tiny nodules.

Hysterosalpingography (HSG)

Tubal occlusion in tuberculosis is considered the most common sign observed on an HSG and
occurs most commonly in the region of isthmus and ampulla. Multiple constrictions along the
course of the Fallopian tube can also form from scarring and give rise to beaded
appearance to the tubes. Scarring can also lead to a rigid pipe stem appearance of the
tubes.

MRI

Tuberculous salpingitis without blockage can appear as a thick walled tortuous structure with
vivid enhancement.

Differential diagnosis
On a hysterosalpingogram consider:

salpingitis isthmica nodosa

See also

pelvic inflammatory disease

tuberculosis