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 Traversing the Spectrum of Non-Langerhans Cell Histiocytosis: A Case of Rosai-Dorfman Disease with Features of Necrobiotic Xanthogranuloma

2021 ◽  
Vol 55 (5) ◽  
Author(s):  
Blythe N. Ke ◽  
Erika Belinda T. Chen ◽  
Kevin Jer V. David ◽  
Sarah Faye V. Obbus ◽  
Val Constantine S. Cua ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Giant Cells ◽  
Skin Lesions ◽  
Neck Mass ◽  
Langerhans Cell ◽  
Cervical Lymph Nodes ◽  
Negative Results ◽  
Skin Nodule ◽  
Rosai Dorfman Disease ◽  
The Face

Introduction. Non-Langerhans cell histiocytoses (non-LCH) are a group of rare diseases with varied clinical manifestations and overlapping features seen among the subtypes. Here, we present a case of Rosai-Dorfman disease with features of necrobiotic xanthogranuloma. Case. A 45-year-old female presented with a 10-year history of an enlarging neck mass with normal overlying skin accompanied by dysphagia and multiple asymptomatic pink to yellowish-brown papules, nodules, and plaques on the face, trunk and extremities. Biopsies of a skin nodule and plaque revealed granulomatous dermal infiltrates (lymphocytes, foamy histiocytes, and Touton giant cells), emperipolesis and areas of necrosis. CD1A and Fite-Faraco staining showed negative results while CD68 and S100 positively stained the tissues of interest. Histopathology of the neck mass paralleled these findings in addition to being negative for lymphoid markers. Patient had monoclonal gammopathy and thyromegaly with enlarged cervical lymph nodes on further tests and imaging. Intralesional and systemic steroids were given which led to flattening of skin lesions and improvement in dysphagia, respectively. Conclusion. Diagnosis and classification of a particular type of non-LCH may be difficult due to similarities across its subtypes. Hence, it is our belief that these diseases may occur on a spectrum. Treatment involves a multidisciplinary approach for the best possible care.

scholarly journals First report of nodular skin lesions caused by Mycobacterium nebraskense in a 9-year-old cat

2018 ◽  
Vol 4 (2) ◽  
pp. 205511691879268 ◽  
Author(s):  
Simone Niederhäuser ◽  
Luzia Klauser ◽  
Jürg Bolliger ◽  
Ute Friedel ◽  
Sarah Schmitt ◽  
...  
Keyword(s):  
Surgical Excision ◽  
Giant Cells ◽  
Skin Lesions ◽  
Multinucleated Giant Cells ◽  
Phenotypic Resistance ◽  
Caseous Necrosis ◽  
Case Summary ◽  
Antimycobacterial Agents ◽  
Skin Nodules ◽  
Granulomatous Dermatitis

Case summary A 9-year-old cat was referred with multiple, raised, ulcerative skin nodules in the region of the neck and dorsal head. Histopathological findings of a biopsied nodule were granulomatous dermatitis and panniculitis without multinucleated giant cells or caseous necrosis. In addition, by Ziehl–Neelsen staining numerous acid-fast intracellular bacilli were observed within the lesions. Mycobacterial culture showed growth of rough scotochromogenic colonies after 3 weeks of incubation. Molecular characterisation of the isolate identified Mycobacterium nebraskense as the cause of the infection. No phenotypic resistance was detected for the antimycobacterial agents tested. The cat was successfully treated with a combination of surgical excision and a 12 week course of antimicrobial therapy, including rifampicin combined with clarithromycin. Relevance and novel information To our knowledge, this is the first documented case of mycobacterial granulomatous dermatitis and panniculitis due to M nebraskense infection in a cat. The successful surgical and antimycobacterial treatment regimen is described.

Cervical Adenitis

1985 ◽  
Vol 7 (1) ◽  
pp. 13-24
Author(s):  
Andrew M. Margileth
Keyword(s):  
Cervical Lymphadenopathy ◽  
Staphylococcal Infection ◽  
The Body ◽  
Cervical Lymphadenitis ◽  
Neck Node ◽  
Cervical Lymph Nodes ◽  
Cervical Adenitis ◽  
Viral Illness ◽  
Infection And Inflammation ◽  
Reactive Hyperplasia

Children with acutely tender and inflamed cervical lymph nodes are observed commonly by family physicians and pediatricians. Cervical lymphadenitis is usually associated with a systemic viral illness and subsides within a few days to 2 weeks. Bacterial adenitis, seen less often, is usually due to (β-hemolytic streptococcal or to staphylococcal infection. However, when a neck node remains enlarged following a systemic illness or when a nontender regional cervical node (adenopathy) persists longer than 2 or 3 weeks with or without associated illness, the physician and parents become worried. Concern is enhanced if the nodes increase in size or number. Infection and inflammation are the most common causes for persistent chronic (3 or more weeks' duration) lymphadenopathy in children. Whereas neoplasm is rare (1.4%) in the child or adolescent less than 17 years of age with a superficial lump on any part of the body, maligancy (Hodgkin disease, lymphoma, neuroblastoma) was found in 31 (13%) of 239 enlarged cervical nodes in similar-aged children at the same institution. Congenital and acquired cysts, pilomatrixomas, and benign neoplasms (lipoma, neurofibroma, lymphangioma) account for the majority of noninflammatory lesions in the neck in children and adolescents. However, most cervical lymphadenopathy in children is due to adenitis or reactive hyperplasia in response to an infection.

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.

TO STUDY THE CYTOMORPHOLOGICAL PATTERNS OF TUBERCULAR LYMPHADENOPATHY AND ITS HISTOPATHOLOGICAL CORRELATION

2021 ◽  
pp. 26-27
Author(s):  
Rashmi Sharma ◽  
Poonum Gogania ◽  
Geeta Pachori ◽  
Akhilesh Bharadwaj
Keyword(s):  
Epithelioid Cell ◽  
Cervical Region ◽  
Tuberculous Lymphadenitis ◽  
Female Ratio ◽  
Caseous Necrosis ◽  
Histopathological Correlation ◽  
Histopathological Evaluation ◽  
Special Stain ◽  
Hematoxylin And Eosin ◽  
Tubercular Lymphadenitis

INTRODUCTION: Tubercular lymphadenopathy is one of the common clinical problems. Practically diagnosis of tuberculosis sometimes creates a challenge to the pathologist and clinician. A combined approach of cytology with aid of special stain and histopathological evaluation helps to conrm the diagnosis. AIM -The present study was carried out to evaluate the different cytological patterns of tuberculous lymphadenitis along with utility of special stain like Acid fast stain and further histopathological evaluation. MATERIAL AND METHOD: Smears from 833 cytologically diagnosed cases of tubercular lymphadenitis were prepared and stained with Hematoxylin and Eosin (H&E), Giemsa and Acid-fast stain. All the smears were categorized into four cytomorphological patterns and correlated with 250 histopathologically available cases. RESULT: Tuberculosis is the major cause of lymphadenopathy. Majority of cases (63 %) were in their second to third decades of life, with male to female ratio of 1:1.4. Cervical region was the most common site of involvement (83.5 %). Smear revealed epithelioid granulomas with caseous necrosis in maximum cases (46.9 %). AFB positivity was seen highest in smear revealing necrosis only with or without epithelioid cell (93,8 %). histopathological correlation was seen in 248 cases out of 250 available cases. CONCLUSION: FNAC has been proved very safe, highly sensitive, and rst line investigation in diagnosing tubercular lymphadenitis. The approach to tubercular lymphadenitis attains completeness with cytopathological, Acid Fast stain and histopathological evaluation.

scholarly journals SPOROTRIKOSIS LIMFOKUTAN DIAGNOSIS HISTOPATOLOGI DAN SITOLOGI

2013 ◽  
Vol 2 (1) ◽  
Author(s):  
Poppy M. Lintong ◽  
Inneke V. Sumolang
Keyword(s):  
Skin Lesion ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Histopathological Examination ◽  
Sporothrix Schenckii ◽  
Giant Cells ◽  
Skin Lesions ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Left Hand

Abstract: Diagnosis of sporotrichosis associated with lymphocutaneous nodules was made based on the histopathological examination of skin lesions and the cytology of fine needle aspiration biopsy (FNAB). A case of sporotrichosis in a 63-year-old man was reported with papules and nodules spread along the back of the left hand, forearm, and arm. The histopatho-logical examination showed infiltration of PMNs, granulomas, and giant cells in the dermis and epidermis, along with hyperplasia and microabscesses. Sporothrix schenckii was not found in the skin lesion tissues. However, in the FNAB cytology examination of lymphocutaneus nodules we found spores of Sporothrix schenckii in the cytoplasma of histiocytes besides granuloma and infiltration of PMNs. Key words: sporothrix schenckii, histopathology, FNAB cytology.  Abstrak: Diagnosis sporotrikosis kulit dengan nodul limfokutan ditegakkan melalui pemerik-saan histopatologi pada lesi kulit dan sitologi biopsi aspirasi jarum halus pada nodul limfo-kutan. Kami melaporkan kasus sporotrikosis pada laki-laki berusia 63 tahun dengan papul-papul dan nodul-nodul eritematosa pada dorsum manus, antebrakium, dan brakium sinistra. Pemeriksaan histopatologi jaringan biopsi dari lesi kulit menunjukkan reaksi radang, gambaran granuloma, dan sel datia dalam dermis dan epidermis, dengan mikroabses disertai hiperplasia. Tidak ditemukan jamur Sporothrix schenckii dalam potongan jaringan histopatologi. Hasil pemeriksaan sitologi biopsi aspirasi jarum halus pada nodul limfokutan memperlihatkan adanya spora-spora jamur Sporothrix schenckii dalam sitoplasma sel-sel histiosit disamping  terdapatnya bentuk granuloma dalam infiltrat radang. Kata kunci: sporothrix schenckii, histopatologi, sitologi biopsi aspirasi jarum halus.

Multicentric reticulohistiocytosis

2013 ◽  
pp. 1447-1450
Author(s):  
Hermann Einsele ◽  
Peter J. Maddison
Keyword(s):  
White Women ◽  
Systemic Disease ◽  
Age At Onset ◽  
Giant Cells ◽  
Skin Lesions ◽  
The Body ◽  
Laboratory Findings ◽  
Multicentric Reticulohistiocytosis ◽  
Recommended Treatment ◽  
Underlying Malignancy

Multicentric reticulohistiocytosis (MRH) is a rare systemic disease characterized by the combination of typical papular and nodular skin lesions and a severe and destructive polyarthritis, although virtually any organ system of the body can be involved. MRH most commonly affects middle-aged white women; it is about three times more common in women with a mean age at onset in the fifth decade. MRH is a rare histiocytic proliferative disease of unknown aetiology, characterized by tissue infiltration by histiocytes and multinuclear giant cells. The stimulus for the histiocytic proliferation has not been fully elucidated, although there is an association with internal malignancies and abnormal immunological laboratory findings. The diagnosis is confirmed by skin or synovial biopsy. The disease often runs a waxing and waning course and sometimes stabilizes. Work-up for underlying malignancy cannot be overemphasized. The recommended treatment for MRH is oral methrotrexate plus prednisone tapered gradually over 3–4 months.

scholarly journals Effect of the Lactococcus Lactis 11/19-B1 Strain on Atopic Dermatitis in a Clinical Test and Mouse Model

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 763 ◽  
Author(s):  
Takato Suzuki ◽  
Kyoko Nishiyama ◽  
Koji Kawata ◽  
Kotaro Sugimoto ◽  
Masato Isome ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Mouse Model ◽  
Lactococcus Lactis ◽  
Skin Lesions ◽  
T Cell Subsets ◽  
Eosinophil Infiltration ◽  
Clinical Test ◽  
Host Immune System ◽  
Cervical Lymph Nodes ◽  
Ad Mouse Model

Some lactic acid bacteria (LAB) are known to improve atopic dermatitis (AD) through the regulation and stimulation of the host immune system. In this study, we found that ingestion of yogurt containing Lactococcus lactis 11/19-B1 strain (L. lactis 11/19-B1) daily for 8 weeks significantly improved the severity scoring of atopic dermatitis (SCORAD) system score from 38.8 ± 14.4 to 24.2 ± 12.0 in children suffering from AD. We tried to identify which LAB species among the five species contained in the test yogurt contributed to the improvement in AD pathology using an AD mouse model induced by repeated application of 1-fluoro-2, 4-dinitrobenzene (DNFB). AD-like skin lesions on the dorsal skin and ear were most improved by L. lactis 11/19-B1 intake among the five LAB species. In addition, analysis of CD4+ T cell subsets in Peyer’s patches (PPs) and cervical lymph nodes (CLNs) indicated that the intake of L. lactis 11/19-B1 generally suppressed all subsets related to inflammation, i.e., Th1, Th2 and Th17, instead of activating the suppressive system, Treg, in the AD mouse model. Histological observations showed ingestion of L. lactis 11/19-B1 significantly suppressed severe inflammatory findings, such as inflammatory cell filtration, epidermal erosion and eosinophil infiltration. These results suggest that the immunomodulatory effects of L. lactis 11/19-B1 contribute to improvements in AD pathology.

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.

scholarly journals Identification of lamb flocks susceptible and resistant against Brachiaria poisoning

2016 ◽  
Vol 36 (5) ◽  
pp. 383-388 ◽  
Author(s):  
Rayane C. Pupin ◽  
Gleice K.A. Melo ◽  
Rubiane F. Heckler ◽  
Tatiane C. Faccin ◽  
Camila C.B.F. Ítavo ◽  
...  
Keyword(s):  
Genetic Resistance ◽  
Clinical Signs ◽  
Giant Cells ◽  
Skin Lesions ◽  
Bile Duct Proliferation ◽  
Subcutaneous Edema ◽  
Lymphoplasmacytic Infiltrate ◽  
The Face ◽  
Resistant Group ◽  
Foamy Macrophages

Abstract: This study was designed to assess the influence of genetic resistance against brachiaria poisoning in sheep. Two groups of sheep, one identified as susceptible (formed by two ewes and one ram) and the other as resistant against brachiaria poisoning (formed by three ewes and one ram) were selected. Sheep considered susceptible were those that presented clinical signs of brachiaria poisoning at any time of their life; resistant sheep were those that even raised on Brachiaria spp. pastures, did not developed any sign of the poisoning during their life. The offspring of the two flocks (15 lambs from the sensitive flock and 9 lambs from the resistant flock) were placed into brachiaria pasture (initially Brachiaria decumbens and B. brizantha,and only B. decumbens after weaning) and followed up during two years (2013-2014). The determination of protodioscin levels in B. decumbens pasture was performed only in 2014 and revealed significant amounts of the toxic principle. Eleven lambs of the susceptible group were affected to some degree of brachiaria poisoning and six died; no lamb of the resistant group was affected. Clinical signs consisted of varying degrees of subcutaneous edema of the face and, erythema and loss of hair of the ears, crusts on the skin of ears, around the eyes and on planum nasale, scar deformation of the ears, and bilateral ocular discharge; affected lambs also sought for shadowy shelters and they were poor doers. Several sheep recovered from the condition and then relapsed. Necropsy findings in six lambs included pale mucous membranes, emaciation, dermatitis, scar deformation of the ears, large yellow livers with marked lobular pattern, and moderate infestation by Haemonchus contortus. Histologically the liver lesions were similar in all necropsied lambs but with varying degrees of severity; they were consistent with brachiaria poisoning and included architectural disruption of hepatocellular trabecula, clusters of foamy macrophages occasionally forming multinucleated giant cells, swollen and vacuolated hepatocytes, crystals or negative images of crystals in the biliary system, bilestasis, bile duct proliferation and lymphoplasmacytic infiltrate in portal triads. The skin lesions were those of photodermatitis and included epidermal necrosis, hyperkeratosis and dermal neutrophilic infiltrate. The results of this study allow to conclude that there is a genetic related resistance to brachiaria poisoning in sheep since the progeny of resistant sheep did not manifest the poisoning. The use of resistant flocks in brachiaria pastures is suggested as a valuable option for the prevention of brachiaria poisoning in sheep.

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