Das K M, Vaidyanathan S, Rajwanshi A, Indudhara R
Department of Radio-diagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
AJR Am J Roentgenol. 1992 Mar;158(3):571-3. doi: 10.2214/ajr.158.3.1738997.
Sonographically guided fine-needle aspiration cytology was performed in 19 patients suspected to have renal tuberculosis. This procedure enabled a diagnosis of renal tuberculosis to be made in six of seven patients with urine cultures consistently negative for acid-fast bacilli and confirmed the diagnosis in nine patients with focal renal lesions on sonography and urine cultures positive for acid-fast bacilli. The fine-needle aspiration cytologic samples were positive for acid-fast bacilli in seven (44%) of the 16 confirmed cases, and acid-fast bacilli were present in 80% of the samples containing necrotic material. Epithelioid granulomas were present in 15 (94%) of 16 patients diagnosed with renal tuberculosis. One patient had no evidence of acid-fast bacilli or epithelioid granulomas, but seminal fluid ultimately grew acid-fast bacilli. Two patients (13%) with evidence of tuberculosis had minor self-limiting complications from the fine-needle aspiration: one perirenal hematoma and one abdominal wall intramuscular hematoma. Sonographically guided fine-needle aspiration cytology is useful as a means of diagnosing renal tuberculosis in patients with urine cultures negative for acid-fast bacilli, and is of value in defining the granulomatous nature of sonographically visible lesions in patients with positive urine cultures.
对19例疑似肾结核的患者进行了超声引导下细针穿刺细胞学检查。该检查方法使得7例尿培养持续未检出抗酸杆菌的患者中有6例得以诊断为肾结核，并在9例超声检查发现局灶性肾病变且尿培养抗酸杆菌阳性的患者中确诊。在16例确诊病例中，有7例（44%）的细针穿刺细胞学样本抗酸杆菌呈阳性，在80%含有坏死物质的样本中存在抗酸杆菌。16例诊断为肾结核的患者中有15例（94%）存在上皮样肉芽肿。1例患者未发现抗酸杆菌或上皮样肉芽肿，但精液最终培养出抗酸杆菌。2例（13%）有结核证据的患者因细针穿刺出现了轻微的自限性并发症：1例肾周血肿，1例腹壁肌内血肿。超声引导下细针穿刺细胞学检查对于尿培养抗酸杆菌阴性的患者是诊断肾结核的一种有用方法，对于尿培养阳性且超声可见病变的患者确定肉芽肿性质具有价值。
