Gupta Mamta, Lobo Flora D, Adiga Deepa Sowkur Anandarama, Gupta Abhishek
Department of Pathology, Subharti Medical College, Swami Vivekananda Subharti University, Meerut, Uttar Pradesh 250002, India.
Department of Pathology, Kasturba Medical College, Mangalore, Manipal University, Karnataka 575001, India.
Patholog Res Int. 2016;2016:8132741. doi: 10.1155/2016/8132741. Epub 2016 Mar 21.
Background. Tuberculosis (TB) is a major cause of morbidity and mortality globally. Many cases are diagnosed on autopsy and a subset of patients may require surgical intervention either due to the complication or sequelae of TB. Materials and Methods. 40 cases of resected lung specimens following surgery or autopsy in which a diagnosis of pulmonary tuberculosis was made were included. Histopathological pattern analysis of pulmonary tuberculosis along with associated nonneoplastic changes and identification of Mycobacterium tuberculosis bacilli was done. Results. The mean age of diagnosis was 41 years with male predominance (92.5%). Tuberculosis was suspected in only 12.1% of cases before death. Seven cases were operated upon due to associated complications or suspicion of malignancy. Tubercular consolidation was the most frequent pattern followed by miliary tuberculosis. The presence of necrotizing granulomas was seen in 33 cases (82.5%). Acid fast bacilli were seen in 57.5% cases on Ziehl-Neelsen stain. Conclusion. Histopathology remains one of the most important methods for diagnosing tuberculosis, especially in TB prevalent areas. It should be considered in the differential diagnosis of all respiratory diseases because of its varied clinical presentations and manifestations.
背景。结核病是全球发病和死亡的主要原因。许多病例是在尸检时确诊的,部分患者可能因结核病的并发症或后遗症而需要手术干预。材料与方法。纳入40例经手术或尸检切除的肺标本,这些标本均诊断为肺结核。对肺结核进行组织病理学模式分析,同时分析相关的非肿瘤性改变并鉴定结核分枝杆菌。结果。诊断时的平均年龄为41岁,男性占优势(92.5%)。死亡前仅12.1%的病例怀疑患有结核病。7例因相关并发症或怀疑恶性肿瘤而接受手术。结核实变是最常见的模式,其次是粟粒性肺结核。33例(82.5%)可见坏死性肉芽肿。萋尼氏染色显示57.5%的病例中可见抗酸杆菌。结论。组织病理学仍然是诊断结核病最重要的方法之一,尤其是在结核病流行地区。由于其临床表现多样,在所有呼吸道疾病的鉴别诊断中均应考虑。