Gynaecology for students and practitioners . may block the cervical canal and give rise to pyometra. This formof tuberculosis is also accompanied by ulceration due to the breakingdown of tuberculous foci. The cervical glands become hypertrophiedand their lumina are filled with serous exudation and round of the epithelium of the glands is often marked, giving aresemblance to squamous-celled epithelioma, which in some caseshas actually been associated with tuberculosis of the cervix. Giant- TUBERCULOSIS OF THE GENERATIVE ORGANS 307 celled systems exist in the infiltrated muscle-
Gynaecology for students and practitioners . may block the cervical canal and give rise to pyometra. This formof tuberculosis is also accompanied by ulceration due to the breakingdown of tuberculous foci. The cervical glands become hypertrophiedand their lumina are filled with serous exudation and round of the epithelium of the glands is often marked, giving aresemblance to squamous-celled epithelioma, which in some caseshas actually been associated with tuberculosis of the cervix. Giant- TUBERCULOSIS OF THE GENERATIVE ORGANS 307 celled systems exist in the infiltrated muscle-tissue surroundingthe glands {see Fig. 147). Signs and Symptoms. The ulcerative condition is often mis-taken clinically for carcinoma, and the latter can be satisfactorilyexcluded only by microscopic examination. A blood-stained leucor-rhoeal discharge, which may be offensive, is present. There is little orno pain, menorrhagia may be noted, there is no fever, and the patientsgeneral condition remains good unless there is tubercle Fig. 147. Tuberculosis of the Cervix Uteri. Showing giant-celJedsystems. A. Gland filled with serous exudation and round cells. A glandat the top of the Figure showed metaplasia of its epithelium. The proliferative type resembles in appearance a pseudo-adenoma{erosion), but ft is soft, friable, and very vascular ; thereis no surrounding infiltration. The tuberculous cervix has beendescribed as looking like a carcinoma and feeling like a is difficult clinically to diagnose a tuberculous ulcer of the cervixfrom a venereal ulcer ; resort must be had to microscopic examina-tion and to Wassermanns test. The prognosis in an isolated cervicallesion is good, but the outlook is often vitiated by the presence oftuberculosis in other parts of the body. The treatment consists of high amputation of the cervix, but ifthere is also advanced phthisis no operative treatment is indicated. 308 GYNECOLOGY Tuberculosis of the Body of the Uterus. T
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
