scholarly journals Bronchoscopic diagnostic procedures and microbiological examinations in proving endobronchial tuberculosis

2016 ◽  
Vol 42 (3) ◽  
pp. 191-195 ◽  
Author(s):  
Abdullah Şimşek ◽  
İlhami Yapıcı ◽  
Mesiha Babalık ◽  
Zekiye Şimşek ◽  
Mustafa Kolsuz
Keyword(s):  
Fine Needle Aspiration Biopsy ◽  
Granulomatous Inflammation ◽  
Diagnostic Procedures ◽  
Needle Aspiration ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Bronchial Brushing ◽  
Endobronchial Tuberculosis ◽  
Proportional Distribution ◽  
Hiv Negative

ABSTRACT Objective: To determine the proportional distribution of endobronchial tuberculosis (EBTB) subtypes and to evaluate the types of bronchoscopic diagnostic procedures that can prove granulomatous inflammation. Methods: This was a retrospective study of 18 HIV-negative patients with biopsy-proven EBTB treated between 2010 and 2014. Results: The most common EBTB subtypes, as classified by the bronchoscopic features, were tumorous and granular (in 22.2% for both). Sputum smear microscopy was performed in 11 patients and was positive for AFB in 4 (36.3%). Sputum culture was also performed in 11 patients and was positive for Mycobacterium tuberculosis in 10 (90.9%). Smear microscopy of BAL fluid (BALF) was performed in 16 patients and was positive for AFB in 10 (62.5%). Culture of BALF was also performed in 16 patients and was positive for M. tuberculosis in 15 (93.7%). Culture of BALF was positive for M. tuberculosis in 93.7% of the 16 patients tested. Among the 18 patients with EBTB, granulomatous inflammation was proven by the following bronchoscopic diagnostic procedures: bronchial mucosal biopsy, in 8 (44.4%); bronchial brushing, in 7 (38.8%); fine-needle aspiration biopsy, in 2 (11.1%); and BAL, in 2 (11.1%). Bronchial anthracofibrosis was observed in 5 (27.7%) of the 18 cases evaluated. Conclusions: In our sample of EBTB patients, the most common subtypes were the tumorous and granular subtypes. We recommend that sputum samples and BALF samples be evaluated by smear microscopy for AFB and by culture for M. tuberculosis, which could increase the rates of early diagnosis of EBTB. We also recommend that bronchial brushing be employed together with other bronchoscopic diagnostic procedures in patients suspected of having EBTB.

scholarly journals It is not always Tuberculosis! A case of pulmonary cryptococcosis in an immunocompetent child in Uganda

2021 ◽  
Vol 21 (3) ◽  
pp. 990-994
Author(s):  
Irene Nakatudde ◽  
Phillip Kasirye ◽  
Sarah Kiguli ◽  
Philippa Musoke
Keyword(s):  
Case Report ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Antigen Test ◽  
Limited Data ◽  
Pulmonary Cryptococcosis ◽  
Immunocompetent Child ◽  
Diagnostic Capacity ◽  
Antimicrobial Treatments ◽  
Hiv Negative

Pulmonary cryptococcosis is rare in immunocompetent individuals. Limited data exist regarding its occurrence in children, especially in developing countries. This case report describes an 8-year-old HIV-negative child with pulmonary cryptococco- sis, previously diagnosed and treated for tuberculosis twice without improvement. Fine needle aspiration biopsy confirmed the diagnosis of pulmonary cryptococcosis and serum cryptococcal antigen test was positive. The child improved on am- photericin and fluconazole treatment. Despite the limited diagnostic capacity in many resource-constrained settings like Uganda, this case report highlights the need to investigate other causes of pneumonia in immunocompetent children that are not improving on conventional antimicrobial treatments. Keywords: Pulmonary cryptococcosis; immunocompetent; children; Uganda.

scholarly journals A Novel Sensitive Immunoassay Targeting the 5-Methylthio-D-Xylofuranose–Lipoarabinomannan Epitope Meets the WHO's Performance Target for Tuberculosis Diagnosis

2018 ◽  
Vol 56 (12) ◽  
Author(s):  
George B. Sigal ◽  
Abraham Pinter ◽  
Todd L. Lowary ◽  
Masanori Kawasaki ◽  
Andra Li ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Point Of Care ◽  
Clinical Samples ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Analytical Sensitivity ◽  
Retrospective Case ◽  
Hiv Negative ◽  
Point Of Care Assay ◽  
Performance Target

ABSTRACTThe only currently commercialized point-of-care assay for tuberculosis (TB) that measures lipoarabinomannan (LAM) in urine (Alere LF-LAM) has insufficient sensitivity. We evaluated the potential of 100 novel monoclonal antibody pairs targeting a variety of LAM epitopes on a sensitive electrochemiluminescence platform to improve the diagnostic accuracy. In the screening, many antibody pairs showed high reactivity to purified LAM but performed poorly at detecting urinary LAM in clinical samples, suggesting differences in antigen structure and immunoreactivity of the different LAM sources. The 12 best antibody pairs from the screening were tested in a retrospective case-control study with urine samples from 75 adults with presumptive TB. The best antibody pair reached femtomolar analytical sensitivity for LAM detection and an overall clinical sensitivity of 93% (confidence interval [CI], 80% to 97%) and specificity of 97% (CI, 85% to 100%). Importantly, in HIV-negative subjects positive for TB by sputum smear microscopy, the test achieved a sensitivity of 80% (CI, 55% to 93%). This compares to an overall sensitivity of 33% (CI, 20% to 48%) of the Alere LF-LAM and a sensitivity of 13% (CI, 4% to 38%) in HIV-negative subjects in the same sample set. The capture antibody targets a unique 5-methylthio-d-xylofuranose (MTX)-dependent epitope in LAM that is specific to theMycobacterium tuberculosiscomplex and shows no cross-reactivity with fast-growing mycobacteria or other bacteria. The present study provides evidence that improved assay methods and reagents lead to increased diagnostic accuracy. The results of this work have informed the development of a sensitive and specific novel LAM point-of-care assay with the aim to meet the WHO's performance target for TB diagnosis.

Fine Needle Aspiration Biopsy: Its Use in the Management of Orbital and Intraocular Tumors

1989 ◽  
Vol 75 (6) ◽  
pp. 589-593 ◽  
Author(s):  
Oronzo Palma ◽  
Nevio Canali ◽  
Paolo Scaroni ◽  
Anna Maria Torri
Keyword(s):  
Fine Needle Aspiration Biopsy ◽  
Radical Surgery ◽  
Diagnostic Procedures ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Benign Lesions ◽  
Intraocular Tumors ◽  
Choice Of Treatment ◽  
Malignant Lesions ◽  
Needle Aspiration Biopsy

In the management of 29 patients by needle aspiration biopsy, a 100 % accuracy was obtained in the diagnosis of intra- and extra-bulbar orbital lesions. The technique did not produce any important traumatic complications; there was moderate subconjunctival hemorrhagic suffusion, which spontaneously resolved. The technique proved to be positive in the diagnostic approach to lesions with a difficult access. Its importance in the choice of treatment is discussed, and its effect on the prognosis of intraocular tumors is emphasized. It can indeed give specific indications for early treatment of malignant lesions and avoid radical surgery of pseudoneoplastic benign lesions. As in other sites, the technique is reliable if it is applied in cooperation with an experienced pathologist. It is simple and rapid, inexpensive and well accepted by patients more than other invasive diagnostic procedures.

scholarly journals A case of nontuberculous mycobacteria-associated thyroiditis mimicking subacute thyroiditis

2021 ◽  
Vol 10 (5) ◽  
pp. 205846012110215
Author(s):  
Hee Joong Lim ◽  
Sang Yu Nam ◽  
Jae Yeon Seok ◽  
Jung Suk An ◽  
Dong Young Kim
Keyword(s):  
Thyroid Gland ◽  
Fine Needle Aspiration Biopsy ◽  
Nontuberculous Mycobacteria ◽  
Granulomatous Inflammation ◽  
Needle Aspiration ◽  
Accurate Diagnosis ◽  
Fine Needle ◽  
Radiological Features ◽  
Thyroid Mass ◽  
Necrotic Debris

We describe a case of nontuberculous mycobacteria infection in the thyroid gland in a 54-year-old woman who had painful thyroid enlargement. Ultrasonography showed ill-defined hypoechoic lesions without increased vascularity in both upper lobes of the thyroid gland. Fine needle aspiration biopsy was performed, and pathology showed granulomatous inflammation with necrotic debris that the pathologist suspected was subacute granulomatous thyroiditis or tuberculosis of the thyroid gland. Nontuberculous mycobacteria infection was confirmed after right hemithyroidectomy. Antimycobacterial therapy was initiated as the treatment of choice. Nontuberculous mycobacteria in the thyroid gland appear to be rare. In clinical practice, however, it should be considered as a differential diagnosis of a painful thyroid mass. For accurate diagnosis, clinical and radiological features plus histological examination are required.

scholarly journals MYCOBACTERIA AND OTHER ACID FAST ORGANISMS ASSOCIATED WITH PULMONARY DISEASE IN JOS, NIGERIA PULMONARY DISEASE AND ACID FAST ORGANISMS

2015 ◽  
Vol 3 (1) ◽  
pp. 15
Author(s):  
Ani AE ◽  
Diarra B ◽  
Dahle UR ◽  
Lekuk C ◽  
Yetunde F ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Diagnostic Procedures ◽  
Adult Patients ◽  
Hiv Positive ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Tuberculosis Complex ◽  
Nocardia Species ◽  
Genotype Assay ◽  
Prompt Diagnosis

Objective: Acid fast bacilli (AFB) for sputum smear microscopy is the affordable method used for prompt diagnosis of tuberculosis in Nigeria despite its lack of specificity and limited sensitivity. The study aims to identify Mycobacterium tuberculosis and other acid fast organisms isolated from sputum of of HIV positive adult patients with pulmonary disease in Jos, Nigeria. Methods: Acid fast organisms isolated from 80 AFB positive sputa of HIV positive adult patients suspected for tuberculosis in Jos, Nigeria were identified for members of M. tuberculosis Complex (M tuberculosis, M bovis, M africanum, M canetti M. microti and M. caprae) by use of spoligootyping, Multiplex Gen Probe, Hain genotype assay and gene sequencing for spoligotype negative isolates. Results: Seven different spoligotypes of M. tuberculosis complex were identified from 70/80 (87.5%) total number of isolates. M. kansasii (1), M. dulvalii (1) Nocardia species (1) and Tsukamurella species (2) were detected from 5/10 spoligotype negative isolates. Conclusion and Recommendation: Although M. tuberculosis is the dominant AFB associated with chronic pulmonary disease in Jos, Nigeria, other clinically relevant mycobacteria were observed in the study. This suggests that other AFB positive microorganisms associated withtuberculosis -like symptoms could be misdiagnosed and incorrectly treated as M. tuberculosis. It is therefore necessary for laboratories in TB high burden countries to step up diagnostic procedures beyond routine smear microscopy.

Purified Protein Derivative: The Vital Part of the Cervical Tuberculous Adenitis Diagnosis

2003 ◽  
Vol 129 (3) ◽  
pp. 245-247 ◽  
Author(s):  
Fikret Çinar ◽  
Saniye Çinar ◽  
Büulent Yilmaz ◽  
Okan Gürsel
Keyword(s):  
Fine Needle Aspiration Biopsy ◽  
Skin Testing ◽  
Diagnostic Procedures ◽  
Mycobacterial Infection ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Purified Protein Derivative ◽  
Diagnostic Protocol ◽  
Neck Masses ◽  
Cervical Adenitis

OBJECTIVE: The purpose of this study was to review the diagnostic procedures for tuberculous cervical adenitis (TCA) and state the most valuable diagnostic protocol. PATIENTS AND METHODS: Fifty-eight patients who presented with progressive, painless, enlarging neck masses and were diagnosed with TCA between 1988 and 1998 at Beyoglu Hospital, Istanbul, were retrospectively reviewed. RESULTS: The chest roentgenograms were normal in all patients. The purified protein derivative skin testing was positive in every case. The fine needle aspiration biopsy was consistent with mycobacterial infection in 27 (46%) of 58 cases, and biopsy results correctly diagnosed TCA in all masses excised. CONCLUSION: Tuberculosis should be considered in the differential diagnosis of the neck masses. Purified protein derivative with detailed history and physical examination should be the first step in the diagnosis.

scholarly journals Fine Needle Aspiration Biopsy (FNAB) in the Diagnosis of Hepatocellular Carcinoma: A Review

2015 ◽  
Vol 53 (3) ◽  
pp. 209-217
Author(s):  
Alexandra Kalogeraki ◽  
Georgios Z. Papadakis ◽  
Dimitrios Tamiolakis ◽  
Iliana Karvela-Kalogeraki ◽  
Mihailos Karvelas-Kalogerakis ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Imaging Study ◽  
Diagnostic Procedures ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Hepatic Arteriography ◽  
Fine Needle ◽  
Needle Aspiration Biopsy

Abstract Hepatocellular carcinoma (HCC) is the fifth more common cause of cancer and the third leading cause of cancer deaths worldwide. Despite advances in surgical and non surgical modalities in the treatment of HCC, a number of controversies regarding appropriate diagnostic procedures continue to evolve. A consensus statement from the European Association for the study of Liver Diseases (EASL) has been formulated to help clinicians standardize diagnostic approaches. In nodules greater than 2 cm diameter in size, diagnosis can be made if any 2 imaging studies (ultrasonography, computed tomography, magnetic resonance imaging or hepatic arteriography) show increased vascularity. Alternatively only one imaging study with an Alpha fetoprotein level more than 400ng/mL is diagnostic. Fine needle aspiration biopsy (FNAB) should be performed in cases of indeterminate radiology and in lesions sized between 1 and 2 cm. The aim of this review is to familiarize pathologists in the FNAB diagnosis of HCC in an appropriate and timely fashion.

scholarly journals Diagnosis of multiple myeloma on based the material obtained by fine needle aspiration biopsy of the lungs

2004 ◽  
Vol 61 (3) ◽  
pp. 327-330
Author(s):  
Radojka Bokun ◽  
Zeljka Tatomirovic ◽  
Vesna Skuletic ◽  
Goran Plavec ◽  
Labud Ristic ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Bone Marrow Aspiration ◽  
Diagnostic Procedures ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Needle Aspiration Biopsy ◽  
Intrathoracic Mass

The patient presented in this paper was admitted to the hospital for the evaluation of radiologically revealed shadow in both lungs. In the course of diagnostic procedures, fine needle aspiration biopsy of the intrathoracic mass was performed. Cytologic analysis of the smear was performed because of clinical suspicion of plasma cell proliferative disease that was confirmed by bone marrow aspiration. Thus, the cytologic finding of intrathoracic lesion preceded the diagnosis of multiple myeloma.

scholarly journals Prolongation of acid-fast bacilli sputum smear positivity in patients with multidrug-resistant pulmonary tuberculosis

2020 ◽  
Author(s):  
Sidwell Mvo ◽  
Benjamin Longo-Mbenza ◽  
Sandeep D. Vasaikar ◽  
Teke Apalata
Keyword(s):  
Conversion Rate ◽  
Cox Regression ◽  
Multidrug Resistant ◽  
Hiv Positive ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Cell Counts ◽  
Conversion Rates ◽  
Mdr Tb ◽  
Hiv Negative

Abstract Background The study sought to determine factors associated with prolonged smear positivity in multidrug-resistant tuberculosis (MDR-TB) patients following an appropriate management.Methods Newly diagnosed patients [(100 MDR-TB and 100 drug-susceptible TB (DS-TB)] were enrolled between June 2017 and May 2018. Clinical and radiological findings were recorded. Sputum samples were collected for Xpert® MTB/RIF and line probe assays (LiPA). Microscopic tests, including smear grading, were performed at baseline, 4, 8 and 12 weeks post anti-TB therapy. Kaplan-Meier and Cox regression analyses were performed using SPSS v23 with ρ set at ≤ 0.05.Results Of the 200 patients (median age of 34.8 years), 114 (57%) were HIV positive. After 12 weeks of treatment, there was a significant microscopy conversion rate among DS-TB patients [43/45 (95.6%)] as compared to MDR-TB patients [54/69 (78.3%)] (ρ = 0.009), all co-infected with HIV. Similarly, among HIV negative patients, a significant microscopy conversion rate was noted among DS-TB patients [48/55(69.6%)] as compared to MDR-TB patients [21/31(30.4%)] (ρ = 0.03). Time to microscopy conversion was 4.58 ± 2.97 weeks and 5.69 ± 3.25 weeks for HIV positive patients aged ≥35 years and <35 years, respectively whilst among HIV negative patients, time to conversion was 5.00 ± 2.83 weeks and 6.86± 3.59 weeks for those aged ≥35 years and <35 years, respectively (ρ = 0.003). There was a significant association between CD4+ T cell counts at initiation of TB treatment and smear microscopy conversion rates after 12 weeks (ρ = 0.010). At 8 weeks of anti-TB therapy, all MDR-TB patients whose baseline smear microscopy score ranged from scanty to 1+ converted negative whilst 25% of patients with score ≥2+ at baseline remained positive at the end of 12 weeks of treatment (ρ = 0.014). Multivariate Cox regression showed that only baseline smear microscopy grade was independently associated with prolonged smear positivity in MDR-TB patients at 12 weeks (ρ = 0.014).Conclusion Baseline microscopy score ≥2+ is key determinant for prolonged MDR-TB smear positivity beyond 12 weeks of anti-TB therapy. This indicator, though less sensitive than culture, can be used in poor resource settings.

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