A bleeding cervical growth is classically considered suggestive of cervical malignancy. However, cervical tuberculosis may present as pseudotumoral lesions closely mimicking carcinoma, leading to diagnostic dilemmas. A 27-year-old nulliparous woman presented with postcoital bleeding and a clinically suspicious cervical growth. Examination revealed an irregular, friable growth involving the external os with contact bleeding. Despite the alarming appearance, liquid-based cytology and human papillomavirus (HPV) testing were negative. Colposcopy was inadequate due to a bulky exophytic growth obscuring the transformation zone. Cervical biopsy revealed granulomatous cervicitis, and Mycobacterium tuberculosis was detected on GeneXpert testing. The patient responded completely to antitubercular therapy, with resolution of the cervical lesion within 2 months. Cervical tuberculosis should be considered in the differential diagnosis of malignancy-mimicking cervical lesions, especially when clinical findings are discordant with cytology and HPV testing. Histopathological confirmation with appropriate molecular testing is essential to avoid misdiagnosis and unnecessary surgical intervention.
Rathore et al. (Mon,) studied this question.