Kumar Suresh, Gupta Pankaj, Sharma Vishal, Mandavdhare Harshal, Bhatia Anmol, Sinha Saroj, Dhaka Narender, Srinivasan Radhika, Dutta Usha, Kocchar Rakesh
1 Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research , Chandigarh, India .
2 Department of Gastroenterology, Postgraduate Institute of Medical Education and Research , Chandigarh, India .
Surg Infect (Larchmt). 2019 Jan;20(1):91-94. doi: 10.1089/sur.2018.165. Epub 2018 Nov 27.
To evaluate the efficacy of ultrasound-guided (USG) fine-needle aspiration cytology examination (FNAC) of the omentum in the diagnosis of abdominal tuberculosis (TB).
Retrospective review was conducted of data from patients who presented with clinically suspected peritoneal TB between June 2016 and April 2018. We included patients in whom imaging showed omental thickening with or without ascites. Additional features that were assessed on imaging included ascites, the presence of mesenteric or retroperitoneal adenopathy, ileocecal thickening, and involvement of solid abdominal organs. Ultrasound-guided FNAC of the omentum was performed using a 22-gauge needle. The cytologic assessment was done for granulomatous inflammation, bacilli on Zeihl-Neelson stain, and for other pathology if any.
During the study period, 35 omental FNACs were done. Of these patients, malignancy was reported in eight (22.8%). Of the remaining 27 patients, positive results for TB were reported in 19 patients (70.4%). In these 19 patients with positive FNAC, the median age was 33 years (range 10-63 years), with eight males (42.1%). Ascites was present in 14 (73.7%), abdominal lymphadenopathy was present in 9 (47.4%), ileocecal thickening and involvement of solid abdominal organs were reported in 3 (15.8%) and 4 (21%) patients, respectively. Granulomatous inflammation was reported in 17 (89.5%) and acid-fast bacilli in 10 (57.6%) patients. The Genexpert analysis was done in two patients, with a positive result in one patient.
Ultrasound-guided FNAC of the omentum is helpful to diagnose abdominal TB in patients having omental thickening with or without other abnormal findings.
评估超声引导下大网膜细针穿刺细胞学检查（FNAC）在腹部结核（TB）诊断中的疗效。
回顾性分析2016年6月至2018年4月临床疑似腹膜结核患者的数据。纳入影像学显示大网膜增厚伴或不伴腹水的患者。影像学评估的其他特征包括腹水、肠系膜或腹膜后淋巴结肿大、回盲部增厚以及腹部实性器官受累情况。使用22号针进行超声引导下大网膜FNAC。对肉芽肿性炎症、齐-尼氏染色的杆菌以及其他任何病理情况进行细胞学评估。
研究期间，共进行了35次大网膜FNAC。其中，8例（22.8%）报告为恶性肿瘤。其余27例患者中，19例（70.4%）TB检测结果为阳性。在这19例FNAC阳性的患者中，中位年龄为33岁（范围10 - 63岁），男性8例（42.1%）。14例（73.7%）有腹水，9例（47.4%）有腹部淋巴结肿大，3例（15.8%）报告有回盲部增厚，4例（21%）患者有腹部实性器官受累。17例（89.5%）报告有肉芽肿性炎症，10例（57.6%）有抗酸杆菌。对2例患者进行了基因专家分析，1例结果为阳性。
超声引导下大网膜FNAC有助于诊断大网膜增厚伴或不伴其他异常表现的腹部TB患者。
