A rare extrapulmonary presentation of tuberculosis: Breast tuberculosis

Key Clinical Message

Breast abscess of long duration can be tubercular origin in both developing and developed countries despite its rarity.

Abstract

A 34-year-old lady presented with painful lump on her breast for 2 months, which was diagnosed with mammary tuberculosis on basis of aspiration cytology and successfully treated with antitubercular drugs. Breast abscess of long duration may be tubercular etiology in both developing and developed nations.

Histological Comparison Of Two Staining Methods In Identification Of Mycobacterium Tuberculosis In Granulomatous Lymphadenitis

BACKGROUND

Tuberculosis, among human bacterial infections is very important disease of modern world and disease has forensic importance. Extra pulmonary infection is also very common. Histopathology of effected tissue is an important diagnostic modality. Demonstration of mycobacterium tuberculosis in granulomas is necessary for definitive diagnosis of tuberculosis, as many different granulomatous diseases may mimic tuberculosis. Study was conducted to see the positivity of mycobacterium Tuberculosis in tuberculous lymphadenitis and comparative difference in two stains.

METHODS

A correctional study on tuberculosis was performed in PGMI Lahore in collaboration with pathology department Ayub medical college Abbottabad. Fifty cases of formalin fixed paraffin embedded tissue block previously diagnosed as tuberculous lymphadenitis on histopathology were selected. Three-micron thick section were taken and stained with Zn stain and Auramin/ Rhodamin stain. The results were compared; statistical analysis was done using 2×2 table.

RESULTS

Out of 33(66%) female and 17 (34%) male patients ranging from 9-80 years 9 (18%) were positive for Mycobacterium Tuberculosis with Zn stain and 21 (42%) were positive in Auramine/ Rhodamine staining procedure.

CONCLUSIONS

Auramine/ Rhodamine staining procedure was superior to Zn staining method for tissue staining of Mycobacterium Tuberculosis.

Cytomorphological patterns of tubercular lymphadenitis and its comparison with Ziehl-Neelsen staining and culture in eastern up. (Gorakhpur region): Cytological study of 400 cases

Background:

Tuberculous lymphadenitis is most common cause of lymphadenopathy in developing countries. Although enormous literature is available on various aspects of the disease including cytological patterns and its incidence in others parts of India and in other countries, only limited literature is available regarding its incidence and morphological spectrum on cytology in eastern parts of Uttar Pradesh in Gorakhpur region.

Aim:

The present study was undertaken to estimate the incidence of tuberculous lymphadenitis in our settings along with its morphological spectrum on cytology as well as to determine the utility of culture of fine needle aspirates in addition to cytology and Ziehl–Neelsen (ZN) staining.

Material and Methods:

Four hundred cases of superficial lymphadenopathy were subjected to fine needle aspiration cytology (FNAC), and in case, smears were stained with Hematoxylin and eosin (H and E), Giemsa, and ZN stain and categorized into three cytomorphological patterns. All the aspirates were inoculated on two sterile Lowenstein Jensen (LJ) medium.

Result:

Out of 400 cases of consecutive lymph nodes aspirated, 180 cases (45%) showed features of tuberculous lymphadenitis. Smears revealed epithelioid granulomas with caseous necrosis in maximum cases (40%). On statistical analysis, difference between group I and group II was found to be significant (P < 0.05); while comparison between groups II and III as well as between groups I and III was found to be statistically insignificant. Overall, acid fast bacilli positivity was seen in 51.6% of the cases.

Conclusion:

FNAC has been proved very safe, highly sensitive, and first line investigation in diagnosing tubercular lymphadenitis. The sensitivity can be further be increased by complementary cytomorphology with acid fast staining. Diagnostic accuracy can further be increased by culture.