A 50-year-old patient presented in August 2010 with heavy and irregular bleeding per vaginum for last 10 months. She had undergone dilatation and curettage (D and C) and cervical biopsy in December 2009 for menorrhagia. Histopathology showed a disordered proliferative phase with chronic cervicitis. Patient received medical management with temporary relief. She had a second episode of menometrorrhagia in March 2010 followed by a repeat D and C. The endometrial curettings was reported as simple hyperplasia without atypia. Her general, local examination and routine investigations were normal.
A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed and the patient was discharged in satisfactory condition on eighth post-operative day. Histology revealed endometrium in proliferative phase and myometrium showed multiple non-necrotizing epithelioid cell granulomas. Stain for AFB, fungal organisms were negative [Figure 1]. No cytomegalovirus inclusion bodies were seen and there was no evidence of vasculitis. Uterine cervix showed chronic cervicitis and bilateral adnexa were unremarkable. Workup for systemic disorders i.e., tuberculosis, vasculitis and sarcoidosis was negative. Patient was asymptomatic at 6 weeks and one year follow-up.