Assessment of the histopathological prototypes of the pleural fluid and granulomatous tissue reaction associated with pleural tuberculosis

Abumossalam, Ahmed Mohammed; Moawd, A.A.; Shebl, Abdelhadi M.

doi:10.1016/j.ejcdt.2014.07.011

Cited by 2 publications

(2 citation statements)

References 17 publications

(16 reference statements)

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“…Generally, a frankly hemorrhagic or even serosanguinous fluid is unlikely to be tuberculous [ 20 , 21 ]. Our study had only two such cases.…”

Section: Discussionmentioning

confidence: 99%

Bacillary Positive Tuberculous Body Fluid Smears: A Perspective on How Fast to Use Acid Fast

Patel¹,

Gochhait²,

Dhandapani³

et al. 2023

Cureus

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Background Tuberculous effusions are common. Classically, they are described as bacteria poor and lymphocyte rich. Our experience, however, has been more varied. We compiled this rare group of bacteria-positive tuberculous fluids to document their cytologic spectrum and to look for possible predictors of bacillary positivity. Methods Fifty-one cases of bacillary positive fluids were identified and their clinicopathological details were noted. Per case, the smear background was assigned as either clear, caseous, suppurative, granular proteinaceous or frankly hemorrhagic. Fine, punched-out vacuoles in the smear background were also noted. The bacillary load in each case was classified from scanty to 3+. Eventually, the clinicopathologic variables were tabulated for frequency and studied for any association with bacillary presence. Results Only 19 of the 51 patients had a history of tuberculosis. Retropositive patients comprised a small proportion (9.8%) and did not always indicate strong (3+) bacillary positivity. The granular proteinaceous background was the most frequent (35%) pattern. Only a suppurative background was associated with strong bacillary positivity. Fine vacuoles were seen almost always with caseous and granular proteinaceous backgrounds but without statistical significance. Conclusion Tuberculous effusions can have diverse smear backgrounds, not necessarily one rich in caseous material. When tuberculosis is known or clinically suspected, non-classical findings such as abundant neutrophils or suppurative background should not dissuade one from requisitioning mycobacterial stains. In fact, acid-fast stains should probably routinely accompany Giemsa slides of clinically idiopathic effusions in endemic areas since it is still the cheapest and fastest method for a conclusive diagnosis.

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“…Generally, a frankly hemorrhagic or even serosanguinous fluid is unlikely to be tuberculous [ 20 , 21 ]. Our study had only two such cases.…”

Section: Discussionmentioning

confidence: 99%

Bacillary Positive Tuberculous Body Fluid Smears: A Perspective on How Fast to Use Acid Fast

Patel¹,

Gochhait²,

Dhandapani³

et al. 2023

Cureus

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“…In one study, positivity was reported in 10% of cases. 4 Culture of pleural biopsy is helpful and is positive in 85% of cases. In our study, material for culture was available in 5 cases and in all the cases culture was positive.…”

Section: Discussionmentioning

confidence: 99%

Role of thoracoscopic pleural biopsy in evaluation of pleural effusion

Afroz¹,

Radha²

2020

IJPO

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Context: Evaluation of a patient with pleural effusion involves clinical, radiological and cytological evaluation of pleural fluid and histological evaluation of pleural biopsy. It is not always possible to identify the exact etiology of pleural effusion based on cytological examination alone. Pleural biopsy is sensitive in up to 91% of cases. Aims: The Aim of the paper is to study the diagnostic yield of thoracoscopic pleural biopsy and to ascertain the etiology of pleural effusions. Materials and Methods: The material for this study is pleural biopsies received in the department of pathology in a tertiary care hospital. A total of 103 biopsies were studied in three years (2013)(2014)(2015). Biopsies were fixed in buffered formalin and routinely processed. A panel of histochemical stains and immuno histochemical markers were done when required. Statistical Analysis used: None Results: A total of 103 biopsies were studied. M: F ratio is 2.1:1. Youngest patient was 16 years and oldest was 80 years. Most common diagnosis was tuberculosis, diagnosed in 32 cases (32.6%), other lesions diagnosed were acute infection 10 cases (10.2%), chronic inflammation 24 cases (24.5%), adenocarcinoma 13 (13.2%), squamous cell carcinoma 5 (5.1), lymphoma 5 (5.1%), mesothelioma four cases(4.08%), one each of small cell carcinoma, poorly differentiated carcinoma, solitary fibrous tumour, xanthogranulomatous inflammation, extra medullary hematopoiesis, benign mesothelial hyperplasia constituting (1.0%) each. Four biopsies were inadequate and excluded from the study. Conclusions: Thoracoscopic pleural biopsy has a very high sensitivity 91% and a specificity of 100% in diagnosing pleural effusions. It is a safe procedure. Material obtained can be used for ancillary techniques in cases of diagnostic dilemmas.

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Assessment of the histopathological prototypes of the pleural fluid and granulomatous tissue reaction associated with pleural tuberculosis

Cited by 2 publications

References 17 publications

Bacillary Positive Tuberculous Body Fluid Smears: A Perspective on How Fast to Use Acid Fast

Bacillary Positive Tuberculous Body Fluid Smears: A Perspective on How Fast to Use Acid Fast

Role of thoracoscopic pleural biopsy in evaluation of pleural effusion

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