Histopathological yield in different types of bronchoscopic biopsies in proven cases of pulmonary tuberculosis.
Loading...
Date
2015-10
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Background: Diagnosis of pulmonary tuberculosis (TB) is difficult and often requires a
lung biopsy. The goal of this retrospective study was to determine the histopathological
parameters useful for diagnosis of pulmonary TB in different types of bronchoscopic
biopsies (transbronchial lung biopsy [TBLB], transbronchial needle aspiration [TBNA],
and bronchial biopsy [BB]). Materials and Methods: The records of patients
diagnosed to have pulmonary TB, over a period of 1‑year were evaluated. Patients
with positive acid‑fast bacilli (AFB) culture and with three bronchoscopic biopsies
including TBLB, TBNA, and BB were included in the study. Selected (14) histological
parameters were evaluated retrospectively in a total of 27 biopsies from 9 patients
with TB after hematoxylin‑eosin and Ziehl‑Neelsen staining. Results: Diagnostic
yield in TBLBs and TBNA was similar for granulomas detection (66.6% each).
Granulomas in TBNA were larger, caseating and confluent as compared to small
interstitial granulomas seen in TBLB. AFB was demonstrated in only one patient
in TBNA. Lymphocytic cell cuffing was seen around most TBLB granulomas. One
patient also showed microfilaria in blood vessel in TBLB. BBs in all patients showed
the presence of goblet cell metaplasia and increased peribronchial plasma cell
infiltrate with or without eosinophils may be indicative of chronic injury. The yield of
granulomas was low in BBs seen in only 2 patients (22.2%). Conclusion: Diagnostic
yield of TBNA and TBLB for granulomas was similar; however, caseation was seen
more frequently in TBNA than on TBLB. Of other histological parameters, bronchial
metaplastic changes and peribronchial plasma cells infiltrate were constant findings
in all tubercular biopsies indicative of chronic injury.
Description
Keywords
Histology, transbronchial lung biopsies, tuberculosis
Citation
Gupta Nalini, Singh Gurmeet C, Rana Manoj K. Histopathological yield in different types of bronchoscopic biopsies in proven cases of pulmonary tuberculosis. Indian Journal of Pathology & Microbiology. 2015 Oct-Dec 58(4): 439-442.