Das D K, Pant J N, Chachra K L, Murthy N S, Satyanarayan L, Thankamma T C, Kakkar P K
Department of Oto-rhino-Larynogology, Maulana Azad Medical College, New Delhi.
Indian J Pathol Microbiol. 1990 Jan;33(1):1-10.
Cytomorphologic features of tuberculous lymphadenitis cases as observed in lymph-node aspirates were analysed and correlated with AFB positivity and bacillary count. Cytologic features were categorized under three major groups, viz. epithelioid granuloma without necrosis, epithelioid granuloma with necrosis and necrosis without epithelioid granulomas. These three major groups showed a distinct trend in respect of their cellular constituents. While cases with appreciable lymphocytic and multinucleated giant cells component showed a significant decreasing trend, cases with neutrophilic infiltration showed an increasing trend (P less than 0.001). In the above three groups, 9.1 percent, 64.7 percent and 77.4 percent respectively showed AFB positivity, the difference being highly significant (P less than 0.001). All 14 cases with very high bacillary count (greater than 50 bacilli per 500 oil immersion field) were associated with necrosis and 71.4% of them neutrophilic infiltration. A univariate analysis revealed that in presence of lymphocytes, epithelioid cells and Langhan's giant cells, AFB positivity was significantly lower while the picture was just the reverse in presence of necrosis and neutrophilic infiltration (P less than 0.001). The odd's rations for all these variables were highly significant (P less than 0.001). However, a multivariate regression analysis revealed that necrosis was the only independent contributing factor towards AFB positivity.
分析了在淋巴结穿刺物中观察到的结核性淋巴结炎病例的细胞形态学特征，并将其与抗酸杆菌阳性和杆菌计数相关联。细胞学特征分为三大类，即无坏死的上皮样肉芽肿、有坏死的上皮样肉芽肿和无上皮样肉芽肿的坏死。这三大类在细胞成分方面呈现出明显的趋势。淋巴细胞和多核巨细胞成分明显的病例呈现出显著的下降趋势，而有嗜中性粒细胞浸润的病例则呈现出上升趋势（P小于0.001）。在上述三组中，分别有9.1%、64.7%和77.4%的病例抗酸杆菌呈阳性，差异具有高度显著性（P小于0.001）。所有14例杆菌计数非常高（每500个油镜视野中杆菌多于50条）的病例均伴有坏死，其中71.4%有嗜中性粒细胞浸润。单因素分析显示，存在淋巴细胞、上皮样细胞和朗汉斯巨细胞时，抗酸杆菌阳性率显著较低，而存在坏死和嗜中性粒细胞浸润时情况则相反（P小于0.001）。所有这些变量的比值比均具有高度显著性（P小于0.001）。然而，多因素回归分析显示，坏死是抗酸杆菌阳性的唯一独立影响因素。
