Patterns of granulomatous responses in TB lymphadenitis and their correlation with treatment outcomes

Saha, Debarshi and Rautela, Komal and *, Ashwani Kumar and *, Pooja K Suresh (2016) Patterns of granulomatous responses in TB lymphadenitis and their correlation with treatment outcomes. Indian Journal of Tuberculosis, 63 (3). pp. 173-175.

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Introduction: Four patterns are noted in aspirates of TB lymphadenitis with or without concomitant HIV. They are granulomatous, necrotizing granulomatous, predominantly necrotizing and necrotizing suppurative designated pattern 1, 2, 3 and 4, respectively. The present study attempted to correlate granulomatous patterns, Acid Fast Bacilli (AFB) density with treatment outcomes. Materials and methods: The MGG and Papanicolaou stained slides of 56 lymphadenitis patients, 38 TB and 18 TB with seropositive HIV were studied for two years. The AFB were stratified into: 0 – nil (1 – ≤1 AFB, 2 – >1 but <10 AFB, 3 – ≥10 AFB)/10 fields. Results: There were 35 males and 21 females. Eleven aspirates demonstrated AFB. TB+HIV lymphadenitis displayed a higher AFB score. TB+HIV lymphadenitis aspirates significantly showed higher grade granulomas and AFB. TB+HIV lymphadenitis required ≥8-month treatment. Granulomas (pattern 3 or 4) but not high AFB scores required longer treatment (>6 months). Treatment of AFB (≥1) often extended to >6 months. Conclusion: TB with seropositive HIV, possibly due to defective immune regulation exhibited granulomas (pattern 3 or 4) necessitating treatment for ≥8 months. Pattern 3 or 4 granulomas irrespective of HIV status demanded >6-month treatment.

Item Type: Article
Uncontrolled Keywords: Tuberculosis HIV Lymphadenitis Granuloma Treatment response
Subjects: Medicine > KMC Mangalore > Pathology
Depositing User: KMCMLR User
Date Deposited: 14 Dec 2016 14:54
Last Modified: 14 Dec 2016 14:54

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