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.

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2015-03-04
2017-11-19
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References

  1. Lönnroth K, Raviglione M, , 2008. Global epidemiology of tuberculosis: prospects for control. Semin Respir Crit Care Med 29: 481491.[Crossref]
  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]
  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.
  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.
  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]
  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]
  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.
  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]
  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]
  10. American Thoracic Society, 2000. Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med 161: 13761395.[Crossref]
  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.
  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.
  13. Shin WS, , 1992. Diagnosis of tuberculosis; serodiagnosis and molecular biologic approach. Tuberc Respir Dis (Seoul) 39: 16.
  14. Long MD, Ellis E, , 2007. Canadian Tuberculosis Standards, 6th ed. Ottawa, Canada: Public Health Agency.
  15. Golden MP, Vikram HR, , 2005. Extrapulmonary tuberculosis: an overview. Am Fam Physician 72: 17611768.
  16. Merino P, Candel FJ, Gestoso I, Baos E, Picazo J, , 2012. Microbiological diagnosis of spinal tuberculosis. Int Orthop 36: 233238.[Crossref]
  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]
  18. Falagas ME, Kouranos VD, Athanassa Z, Kopterides P, , 2010. Tuberculosis and malignancy. Q J Med 103: 461487.[Crossref]
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  • Received : 19 Oct 2014
  • Accepted : 11 Nov 2014

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