scholarly journals Disseminated tuberculosis caused by Mycobacterium bovis presenting as a tongue base mass

2018 ◽  
pp. bcr-2018-225436
Author(s):  
Sarah Pratt ◽  
Arthur Henderson ◽  
Stuart Gillett
Keyword(s):  
Mycobacterium Bovis ◽  
Systemic Treatment ◽  
Intestinal Tuberculosis ◽  
Granulomatous Inflammation ◽  
Clinical History ◽  
Giant Cells ◽  
Right Hemicolectomy ◽  
Caseous Necrosis ◽  
Detailed Clinical History ◽  
Progressive Weight Loss

An 80-year-old woman presented with dysphagia, odynophagia and progressive weight loss. Initial investigations suggested a large base of tongue squamous cell carcinoma. At panendoscopy, biopsies were taken which revealed granulomatous inflammation with multinucleated giant cells and areas of caseous necrosis. Acid-fast bacilli were identified on Ziehl-Neelsen stain and the appearances were consistent with Mycobacterium bovis. Closer inspection of the patient’s medical history revealed that she had previously undergone right hemicolectomy for an ascending colon stricture. The histology had shown granulomatous inflammation consistent with intestinal tuberculosis but no systemic treatment had been instigated at the time. This case highlights the importance of taking a detailed clinical history as well as the need to be cognisant of tuberculosis masquerading as cancer in the head and neck.

Comparison of Polymerase Chain Reaction With Histopathologic Features for Diagnosis of Tuberculosis in Formalin-Fixed, Paraffin-Embedded Histologic Specimens

2003 ◽  
Vol 127 (3) ◽  
pp. 326-330 ◽  
Author(s):  
Do Youn Park ◽  
Jee Yeon Kim ◽  
Kyung Un Choi ◽  
Jin Sook Lee ◽  
Chang Hun Lee ◽  
...  
Keyword(s):  
Chronic Inflammation ◽  
Granulomatous Inflammation ◽  
Giant Cells ◽  
Caseous Necrosis ◽  
Formalin Fixed Paraffin ◽  
Formalin Fixed Paraffin Embedded ◽  
Type Giant ◽  
Tb Pcr ◽  
Formalin Fixed ◽  
Histopathologic Features

Abstract Objective.—To investigate the relationship between various histopathologic features and the results of the tuberculosis (TB)–polymerase chain reaction (PCR) method in routinely submitted histologic specimens for the histopathologic diagnosis of TB. Design.—We used 95 formalin-fixed, paraffin-embedded tissue blocks from 81 patients who were clinically suspected of having TB. We assessed the presence of histopathologic features including well-formed granuloma, poorly formed granuloma, caseous necrosis, and Langhans-type giant cells. We performed nested PCR for IS6110 and Ziehl-Neelsen staining for acid-fast bacilli (AFB). Results.—Of the 81 patients studied, 53 patients had chronic granulomatous inflammation, whereas 28 patients had only chronic inflammation without definite granulomatous inflammation. Of the 53 cases with chronic granulomatous inflammation, 17 (32%) were AFB positive and 36 (68%) were TB-PCR positive. Among cases with chronic granulomatous inflammation, the percentage that were positive and negative by TB-PCR differed significantly with the presence of various histopathologic features. All of the 13 cases with well-formed granuloma, caseous necrosis, and Langhans-type giant cells were TB-PCR positive; however, 10 (36%) of the 28 cases with chronic inflammation without granulomatous lesions were also TB-PCR positive. Conclusions.—TB-PCR is a rapid, sensitive method for the diagnosis of TB in routinely processed formalin-fixed, paraffin-embedded histologic specimens and is readily available in histopathology laboratories. We recommend use of TB-PCR when TB is suspected clinically, especially in cases of chronic inflammation without definite evidence of granulomatous inflammation.

Medico-Social Factors, Epidemiological and Clinico-Morphological Features of Co-Infection of HIV/TB on Example of the Volgograd Region

10.12737/3563 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 1-5
Author(s):  
Морозова ◽  
N. Morozova ◽  
Козырев ◽  
O. Kozyrev ◽  
Смирнов ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Drug Users ◽  
Granulomatous Inflammation ◽  
Giant Cells ◽  
Vulnerable Groups ◽  
Caseous Necrosis ◽  
Morphological Aspects ◽  
Volgograd Region ◽  
Pathologic Features ◽  
Immunodeficiency Virus

The purpose of this paper is to review the epidemiological, socio-medical, clinical and morphological aspects of the two infections of HIV and tuberculosis to clarify the characteristics of patients and to identify pathologic features of granulomatous inflammation in co-infection with HIV / TB at the level of light microscopy. The material of the research was medical records of patients, who died and persons consisting on the dispensary with HIV infection, tuberculosis and co-infection with HIV / tuberculosis. Morphological part of the research was carried out with the study of autopsy material of death patients with HIV infection and tuberculosis in the Volgograd region. The increase in the number of HIV-infected and high rates of TB in the Volgograd region affect on the epidemic process in co-infecciosa due vulnerable groups and socio against non-adaptable layers of population, which in most cases neglected complete therapy, ARVs and anti-TB therapy and are drug users, on the background of which there is a progression of human immunodeficiency virus and tuberculosis. Morphological research of deceased persons from the co-infection HIV/TB can detect the violation of structure of classical tuberculosis granuloma. In tubercular granuloma except tricks caseous necrosis, surrounded by few epitelialna cells, isolated multinucleated giant cells Pirogov-Langhans,a small number of small lymphocytes were identified, and the appearance on the periphery of neutrophilic leukocytes and severe exudative reaction was revealed.

scholarly journals Incidental Mycobacterium-induced granulomatous inflammation of the follicular pharyngeal tonsils in a South African farmed ostrich (Struthio camelus)

2013 ◽  
Vol 84 (1) ◽  
Author(s):  
Martina R. Crole ◽  
John T. Soley ◽  
Sarah J. Clift
Keyword(s):  
Periodic Acid ◽  
Granulomatous Inflammation ◽  
Giant Cells ◽  
Lymphoid Cells ◽  
Presumptive Diagnosis ◽  
Periodic Acid Schiff ◽  
Tissue Mass ◽  
Caseous Necrosis ◽  
Mycobacterium Spp ◽  
Apparently Healthy

Avian mycobacteriosis (AM) is a zoonotic disease caused by Mycobacterium aviumcomplex (MAC), which can spread from avians to other farmed animals such as cattle and pigs as well as to humans. This study is the first report of granulomatous inflammation, as a result of avian mycobacteriosis, in the follicular pharyngeal tonsils of a farmed ostrich. The head of an apparently healthy farmed adult ostrich was obtained after slaughter. Each pharyngeal fold displayed a large tissue mass. This tissue was routinely prepared for light microscopy and stained with haematoxylin and eosin, periodic acid Schiff, Grocott methenamine silver, Gram and Ziehl-Neelsen. Immunohistochemistry (IHC) and polymerase chain reaction (PCR) were performed to identify Mycobacterium spp. and Mycobacterium tuberculosis complex, respectively. Histologically, the tissue masses consisted of confluent mature micro-granulomata that were characterised by central caseous necrosis surrounded by multinucleated giant cells, macrophages and lymphoid cells and an outer mature fibrous connective tissue capsule. Within some foci of caseous necrosis were variably sized colonies of small, Gram-negative, acid-fast bacilli, which showed positive IHC labelling for Mycobacterium spp., leading to a presumptive diagnosis of AM. PCR thus proved useful in excluding the presence of notifiable Mycobacteriumspp. The significance and role of the pharyngeal tonsils of ratites in diseases such as AM warrant specific attention. Moreover, as ratites are known to present with AM infections with apparently no visible loss in body condition, as presumably occurred in the present case, it is imperative that unusual masses in apparently healthy ratites be thoroughly investigated.

scholarly journals Lesion Development in White-tailed Deer (Odocoileus virginianus) Experimentally Infected with Mycobacterium bovis

2002 ◽  
Vol 39 (3) ◽  
pp. 334-340 ◽  
Author(s):  
M. V. Palmer ◽  
W. R. Waters ◽  
D. L. Whipple
Keyword(s):  
Lymph Node ◽  
Mycobacterium Bovis ◽  
Central Zone ◽  
Giant Cells ◽  
Retropharyngeal Lymph Node ◽  
Lesion Development ◽  
Caseous Necrosis ◽  
Colony Forming Units ◽  
Type Giant ◽  
Lung Lobes

The recent discovery of tuberculosis in free-living white-tailed deer in northeastern Michigan underscores the need for increased understanding of the pathogenesis of tuberculosis in wildlife species. To investigate lesion development in white-tailed deer, 32 deer were experimentally infected by intratonsilar instillation of 300 colony-forming units of Mycobacterium bovis. Three deer each were euthanatized and examined at days 15, 28, 42, and 56 after inoculation, and five deer each were euthanatized and examined at days 89, 180, 262, and 328 after inoculation. Microscopic lesions first were seen in the medial retropharyngeal lymph node and lung 28 and 42 days after inoculation, respectively. Lung lesions were present in 12 (38%) of 32 deer, involving 23 lung lobes. Left caudal and right middle and caudal lobes were involved in 17 (74%) of the 23 affected lung lobes. Lesions in the medial retropharyngeal lymph node first appeared as granulomas composed of aggregates of macrophages and Langhans-type giant cells. Some early granulomas contained centrally located neutrophils. As granulomas developed, neutrophils were replaced with a central zone of caseous necrosis that first showed signs of mineralization 42 days after inoculation. Granulomas increased in size as the zone of caseous necrosis expanded. Peripheral fibrosis, first seen at 56 days after inoculation, progressed to only a thin fibrous capsule by 328 days after inoculation. By the termination of the study, the central necrotic core of the granuloma contained abundant liquefied necrotic material and grossly resembled an abscess. Although tuberculous lesions in white-tailed deer follow a developmental pattern similar to that in cattle, fibrosis is less pronounced and the advanced lesions may liquefy, a change seldom reported in cattle. An understanding of lesion development will aid in the identification of the spectrum of disease that may be seen in this important wildlife reservoir of tuberculosis.

scholarly journals The Value of Imaging Methods in the Diagnosis of the Renal Cell Carcinoma Combined with Renal Tuberculosis – Case Report

2013 ◽  
Vol 1 (1) ◽  
pp. 90-92
Author(s):  
Tania Tsocheva ◽  
Regina Djerassi ◽  
Aleksandrina Vlahova ◽  
Mila Liubomirova ◽  
Boris Bogov
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Histological Examination ◽  
Renal Cell ◽  
Granulomatous Inflammation ◽  
Giant Cells ◽  
Epithelioid Cell ◽  
Tuberculosis Case ◽  
Imaging Methods ◽  
Caseous Necrosis

We describe a case of renal cell carcinoma which causes difficulties to set diagnosis with imaging methods. The histological examination revealed renal cell carcinoma associated with epithelioid cell granuloma with caseous necrosis. Granulomatous inflammation is characterized by the accumulation of epithelioid histiocytes and multinucleated giant cells. The cause of granuloma formation can be infectious or non-infectious. Granulomatous response in renal cell carcinoma is rare. This case shows that for accurate diagnosis for suspected tumor is necessary to be used combination of complex imaging - triplex ultrasound, CEUS, CT and histological examination.

scholarly journals Hepatocellular carcinoma with regional lymphadenopathy caused by sarcoid-like reaction: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Tomoko Mizota ◽  
Masato Suzuoki ◽  
Saya Kaku ◽  
Kenichi Mizunuma ◽  
Kazuto Ohtaka ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Granulomatous Inflammation ◽  
Giant Cells ◽  
Epithelioid Cell ◽  
Imaging Modalities ◽  
Hepatoduodenal Ligament ◽  
Regional Lymph Nodes ◽  
Multiple Imaging

Abstract Background Sarcoid-like reaction (SLR) is a histological pattern of granulomatous inflammation that is clinically differentiated from sarcoidosis. Since SLR is known to occur in several neoplasias and occasionally causes lymphadenopathy and mimics metastatic malignancy, it needs to be considered whether lymphadenopathy is due to metastasis or SLR for the choice of cancer treatment. Few cases of hepatocellular carcinoma (HCC) with SLR have been reported. Here, a case of HCC with lymphadenopathy diagnosed as SLR without metastasis is presented. Case presentation A 69-year-old woman was admitted to our hospital because of upper abdominal pain. She tested positive for hepatitis C virus ribonucleic acid. Imaging modalities showed an 81 × 65-mm-sized tumor with multiple nodules in segment 3 and a 17 × 12-mm-sized tumor in segment 5 with a common HCC enhancement pattern. In addition, a lymph node in the hepatoduodenal ligament was enlarged at 13 mm in size, suggesting the metastasis of HCC. Hepatectomy of the lateral segment and segment 5 and lymph node dissection in the hepatoduodenal ligament were performed. Both tumors in segments 3 and 5 were pathologically diagnosed as HCC without vessel invasion. The tumors contained necrotic cells and epithelioid cell granulomas with multinucleated giant cells, which is typically observed in sarcoidosis. The dissected lymph nodes also contained epithelioid cell granulomas, as well as giant cells with asteroid bodies. There was no malignancy in the lymph nodes. The pathological findings suggested the coexistence of malignancy and sarcoidosis. However, since the patient did not show any typical findings of pulmonary or cardiac sarcoidosis, the case was diagnosed as HCC with SLR in the primary lesion and regional lymph nodes. Conclusions SLR needs to be considered in the differential diagnosis when a cancer patient develops lymphadenopathy. However, lymphadenopathy due to SLR is indistinguishable from that due to metastasis even when using multiple imaging modalities. Pathological examinations may be helpful for the diagnosis.

scholarly journals Virally Activated CD8 T Cells Home to Mycobacterium bovis BCG-Induced Granulomas but Enhance Antimycobacterial Protection Only in Immunodeficient Mice

2006 ◽  
Vol 75 (3) ◽  
pp. 1154-1166 ◽  
Author(s):  
Laura H. Hogan ◽  
Dominic O. Co ◽  
Jozsef Karman ◽  
Erika Heninger ◽  
M. Suresh ◽  
...  
Keyword(s):  
T Cells ◽  
T Cell ◽  
Mycobacterium Bovis ◽  
Cd8 T Cells ◽  
Bacterial Load ◽  
Granulomatous Inflammation ◽  
Cd8 T Cell ◽  
Activated T Cells ◽  
Immunodeficient Mice ◽  
Ifn Γ

ABSTRACT The effect of secondary infections on CD4 T-cell-regulated chronic granulomatous inflammation is not well understood. Here, we have investigated the effect of an acute viral infection on the cellular composition and bacterial protection in Mycobacterium bovis strain bacille Calmette-Guérin (BCG)-induced granulomas using an immunocompetent and a partially immunodeficient murine model. Acute lymphocytic choriomeningitis virus (LCMV) coinfection of C57BL/6 mice led to substantial accumulation of gamma interferon (IFN-γ)-producing LCMV-specific T cells in liver granulomas and increased local IFN-γ. Despite traffic of activated T cells that resulted in a CD8 T-cell-dominated granuloma, the BCG liver organ load was unaltered from control levels. In OT-1 T-cell-receptor (TCR) transgenic mice, ovalbumin (OVA) immunization or LCMV coinfection of BCG-infected mice induced CD8 T-cell-dominated granulomas containing large numbers of non-BCG-specific activated T cells. The higher baseline BCG organ load in this CD8 TCR transgenic animal allowed us to demonstrate that OVA immunization and LCMV coinfection increased anti-BCG protection. The bacterial load remained substantially higher than in mice with a more complete TCR repertoire. Overall, the present study suggests that peripherally activated CD8 T cells can be recruited to chronic inflammatory sites, but their contribution to protective immunity is limited to conditions of underlying immunodeficiency.

NONTUBERCULOUS ACID-FAST BACILLI IN CERVICAL ADENITIS

PEDIATRICS ◽  
1957 ◽  
Vol 20 (4) ◽  
pp. 688-697
Author(s):  
Haddow M. Keith ◽  
Lyle A. Weed ◽  
Gerald M. Needham
Keyword(s):  
Giant Cells ◽  
Skin Lesions ◽  
Mycobacterium Ulcerans ◽  
Cervical Region ◽  
Tubercle Bacillus ◽  
Cervical Lymph Nodes ◽  
Caseous Necrosis ◽  
Acid Fast Bacilli ◽  
Cervical Adenitis ◽  
Bona Fide

THE TUBERCLE bacillus is the most common cause of lymphadenitis with caseous necrosis. Such a condition in the cervical region, while less frequent than in previous decades, still occurs occasionally. While other agents, for example, Coccidioides, Histoplasma, Brucella, Pasteurella and Miyagawanella, are known to produce a similar histopathologic reaction, they are not commonly associated with lesions in the cervical lymph nodes, especially in children. Therefore the finding of acid-fast bacilli in such lesions has generally been considered bona fide evidence of tuberculosis, although previous reports from this clinic indicate that such is not necessarily true. It is recognized that there are other acid-fast bacilli, such as the lepra and smegma bacilli, which may or may not cause disease. In 1944 Gellerstedt reported seven cases of tuberculoid skin lesions due to atypical acid-fast bacilli. He considered these to be due to exogenous infection with acid-fast bacilli differing from the organisms found in tuberculosis, and he considered them as possibly saprophytic organisms. In 1948 MacCallum and co-workers reported six cases of skin lesions due to acid-fast organisms that were not Mycobacterium tuberculosis. The lesions did not contain tubercle follicles, giant cells or caseous material. The name "Mycobacterium ulcerans" was applied to these organisms by Australian workers. In 1954 Linnell and Nordén described skin lesions that occurred in 80 boys and girls who used a certain swimming pool in a Swedish town. The etiologic organisms were acid fast, differed from those described by MacCallum and associates and were not lepra bacilli. Guinea pigs injected with these organisms presented no evidence of lesions after 7 weeks.

scholarly journals Study of etiological factors in unilateral maxillary chronic sinusitis

2016 ◽  
Vol 3 (1) ◽  
pp. 88
Author(s):  
D. Chandrika ◽  
Anantharaju G. S.
Keyword(s):  
Maxillary Sinusitis ◽  
Clinical History ◽  
Causative Factor ◽  
Successful Outcome ◽  
Dental Infection ◽  
Deviated Nasal Septum ◽  
Detailed Clinical History ◽  
Chronic Maxillary Sinusitis ◽  
Symptoms And Signs

<p class="abstract"><strong>Background:</strong> Chronic rhinosinusitis is an extremely prevalent disorder which has significant effect on quality of life of affected individual. Varied symptomatology and varied etiology of unilateral chronic maxillary rhinosinusitis requires a comprehensive approach by otorhinolaryngologist. The objectives of the study were to evaluate the causative factor of unilateral chronic maxillary sinusitis and to study clinical presentation of unilateral chronic maxillary sinusitis<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> 50 patients with symptoms and signs suggestive of unilateral chronic maxillary sinusitis were evaluated. All were subjected to detailed clinical history, ENT examination including complete orodental examination, diagnostic nasal endoscopy, intra oral peri apical radiographs, CT scan of para nasal sinuses<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> Of total of 50 patients studied, gross deviated nasal septum (DNS) is commonest cause of chronic unilateral maxillary sinusitis followed by dental infection of upper premolars<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> This study was carried out with an effort to find out etiology of unilateral chronic maxillary sinusitis as identification of etiology will help in successful outcome of the treatment<span lang="EN-IN">.</span></p>

scholarly journals CLINICAL STUDY OF PAIN IN RIGHT ILIAC FOSSA

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Saurabh Kothari ◽  
Manjula Kothari ◽  
Shree Mohan Joshi ◽  
Kalp Shandilya
Keyword(s):  
Iliac Fossa ◽  
Signs And Symptoms ◽  
Clinical History ◽  
X Ray ◽  
Pain Abdomen ◽  
Detailed Clinical History ◽  
Right Iliac Fossa Pain ◽  
Chest X Ray ◽  
The Right ◽  
Appendicular Mass

Background: A mass in the right iliac fossa is a common diagnostic problem encountered in clinical practice, requiring skill in diagnosis. Methods: 100 patients with signs and symptoms of right iliac fossa mass admitted in Hospital were identified and were studied by taking detailed clinical history, physical examination and were subjected to various investigations like x ray erect abdomen, chest x-ray, contrast x-ray . Result: In this study of out of 100 cases, 65.00% of cases were related to appendicular pathology either in the form of appendicular mass or appendicular abscess. There were 12.00% cases of ileocaecal tuberculosis. Conclusion: Appendicular lump remains the most common cause for right iliac fossa pain. Ileocaecal tuberculosis is one of the most important differential diagnoses for pain abdomen. Keywords: Appendicular Mass, Ileocaecal Tuberculosis, Carcinoma Caecum, Right Iliac Fossa Mass.

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