A 63 year old nulliparous woman from South Asia presents with irregular vaginal bleeding for 4 months. Her menopause occurred 13 years ago. She is not on hormone replacement therapy. A pap smear performed 5 years ago was normal. Her medical history is unremarkable, and she is not on any drugs.
WBC/DC: 8,000/mm3 (4,600-11,000) Hb: 11.0 g/dL (11-18) Platelets: 380,000/mm3 (150,000-400,000)
The endometrial thickness is 8mm; there are no adnexal masses; both ovaries appear normal.
There is granulomatous endometritis with microabscesses within the endometrial glands; numerous noncaseating granulomas and epithelioid clusters with giant cells are noted.
Negative for AFB PCR positive for M. Tuberculosis Culture results will be available in 3 weeks