Female genital tract tuberculosis with peritoneal involvement: CT and MR imaging features

Female genital tract tuberculosis with peritonitis is an uncommon disease in developed countries but is not infrequently reported in patients from developing countries. We report on two immigrants from developing countries presenting with female genital tract tuberculosis and peritonitis as part of miliary tuberculosis. On CT and MR imaging, the involvement was characterized by heterogeneous tubo-ovarian masses, dilated fallopian tubes with thickened wall and increased enhancement, heterogeneous uterine enhancement along with ascites, thickened peritoneum, omental masses and enlarged lymph nodes. In the appropriate clinical setting, especially when other manifestations of miliary tuberculosis are present, these findings should suggest the diagnosis of female genital tract tuberculosis. Laparoscopy and, in advanced cases, minilaparotomy with tissue biopsy for histopathological examination is often recommended for final diagnosis.