1921
Volume 92, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Although chronic granulomatous inflammation (CGI) with concomitant caseous necrosis (CN) is a characteristic histological feature of tuberculosis (TB), few studies have investigated its frequency or various pathologic findings. The medical records of 227 human immunodeficiency virus (HIV) -negative, culture-positive TB patients who underwent biopsy were studied. After the frequency of characteristic pathological findings of TB was determined, a pathologist reanalyzed the pathological findings with particular focus on necrosis and reclassified CGI, CN, or possible CN into possible TB pathologic findings. The initial biopsy interpretation revealed that 63 (34.8%) of 181 patients with pulmonary TB had caseating granulomas, 36 (19.9%) patients had only CGI, and 6 (3.3%) patients had only CN. Among 46 patients with extrapulmonary TB, 16 (34.8%) patients had only caseating granulomas, and 14 (30.4%) patients had only CGI. More patients who underwent percutaneous lung biopsy had CGI or CN (76.3%) than patients who underwent transbronchial lung biopsy (53.6%). The reanalysis confirmed all CN cases identified by the first interpretation, and 20 (95.2%) of 21 non-CN cases were reclassified as possible CN. Ten cases (three pulmonary and seven extrapulmonary) were reclassified as possible TB pathologic findings from just necrosis. Caseating granuloma was present in only one-third of TB cases. Even in cases where only necrosis was identified, CN may be present.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.14-0656
2015-03-04
2020-05-25
Loading full text...

Full text loading...

/deliver/fulltext/14761645/92/3/636.html?itemId=/content/journals/10.4269/ajtmh.14-0656&mimeType=html&fmt=ahah

References

  1. Lönnroth K, Raviglione M, 2008. Global epidemiology of tuberculosis: prospects for control. Semin Respir Crit Care Med 29: 481491.[Crossref]
    [Google Scholar]
  2. Dye C, Watt CJ, Bleed DM, Hosseini SM, Raviglione MC, 2005. Evolution of tuberculosis control and prospects for reducing tuberculosis incidence, prevalence, and deaths globally. JAMA 293: 27672775.[Crossref]
    [Google Scholar]
  3. Klatt EC, 2013. Pathology of Tuberculosis. The Internet Pathology Laboratory for Medical Education. Available at: http://www-medlib.med.utah.edu/WebPath/TUTORIAL/MTB/MTB.html. Accessed October 10, 2013.
    [Google Scholar]
  4. Ajantha GS, Shetty PC, Kulkarni RD, Biradar U, 2013. PCR as a diagnostic tool for extra-pulmonary tuberculosis. J Clin Diagn Res 7: 10121015.
    [Google Scholar]
  5. Chakravorty S, Sen MK, Tyagi JS, 2005. Diagnosis of extrapulmonary tuberculosis by smear, culture, and using universal sample processing technology. J Clin Microbiol 43: 43574362.[Crossref]
    [Google Scholar]
  6. Cutler RR, Baithun SI, Doran HM, Wilson P, 1994. Association between the histological diagnosis of tuberculosis and microbiological findings. Tuber Lung Dis 75: 7579.[Crossref]
    [Google Scholar]
  7. Park DY, Kim JY, Choi KU, Lee JS, Lee CH, Sol MY, Suh KS, 2003. Comparison of polymerase chain reaction with histopathologic features for diagnosis of tuberculosis in formalin-fixed, paraffin-embedded histologic specimens. Arch Pathol Lab Med 127: 326330.
    [Google Scholar]
  8. Kivihya-Ndugga L, van Cleeff M, Juma E, Kimwomi J, Githui W, Oskam L, Schuitema A, van Soolingen D, Nganga L, Kibuga D, Odhiambo J, Klatser P, 2004. Comparison of PCR with the routine procedure for diagnosis of Tuberculosis in a population with high prevalences of tuberculosis and human immunodeficiency virus. J Clin Microbiol 42: 10121015.[Crossref]
    [Google Scholar]
  9. Almeda J, Garcia A, Gonzalez J, Quinto L, Ventura PJ, Vidal R, Rufi G, Martinez JA, Jimenez de Anta MT, Trilla A, Alonso PL, 2000. Clinical evaluation of an in-house IS6110 polymerase chain reaction for diagnosis of tuberculosis. Eur J Clin Microbiol Infect Dis 19: 859867.[Crossref]
    [Google Scholar]
  10. American Thoracic Society, 2000. Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med 161: 13761395.[Crossref]
    [Google Scholar]
  11. Kim JH, Jang SJ, Moon DS, Park YJ, 2003. Evaluation of two PCR-hybridization methods for the detection of Mycobacterium tuberculosis . Korean J Lab Med 23: 3238.
    [Google Scholar]
  12. Lee KE, Cho JH, Moon YH, 1998. Comparison of stain methods with PCR and culture for the detection of Mycobacterium tuberculosis in the sputum. Korean J Clin Pathol 18: 201207.
    [Google Scholar]
  13. Shin WS, 1992. Diagnosis of tuberculosis; serodiagnosis and molecular biologic approach. Tuberc Respir Dis (Seoul) 39: 16.
    [Google Scholar]
  14. Long MD, Ellis E, 2007. Canadian Tuberculosis Standards, 6th ed. Ottawa, Canada: Public Health Agency.
    [Google Scholar]
  15. Golden MP, Vikram HR, 2005. Extrapulmonary tuberculosis: an overview. Am Fam Physician 72: 17611768.
    [Google Scholar]
  16. Merino P, Candel FJ, Gestoso I, Baos E, Picazo J, 2012. Microbiological diagnosis of spinal tuberculosis. Int Orthop 36: 233238.[Crossref]
    [Google Scholar]
  17. Brenner AV, Wang Z, Kleinerman RA, Wang L, Zhang S, Metayer C, Chen K, Lei S, Cui H, Lubin JH, 2001. Previous pulmonary diseases and risk of lung cancer in Gansu Province, China. Int J Epidemiol 30: 118124.[Crossref]
    [Google Scholar]
  18. Falagas ME, Kouranos VD, Athanassa Z, Kopterides P, 2010. Tuberculosis and malignancy. Q J Med 103: 461487.[Crossref]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.14-0656
Loading
/content/journals/10.4269/ajtmh.14-0656
Loading

Data & Media loading...

  • Received : 19 Oct 2014
  • Accepted : 11 Nov 2014
  • Published online : 04 Mar 2015
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error