Lymph Node Aspirates Research Articles

Clinical value of endobronchial ultrasound-guided aspiration and local isoniazid injection in the treatment of mediastinal tuberculous lymphadenitis.

This study aimed to investigate the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) guided purulence aspiration and local isoniazid injection after lymph node puncture in the treatment of refractory mediastinal tuberculous lymphadenitis (MTLA) as compared to systemic anti-tuberculosis treatment. This was a retrospective study. A total of 92 patients with MTLA and suppurative lymphadenitis who were treated in the Shanghai Pulmonary Hospital between January 2015 and December 2018 were included into present study and divided into systemic chemotherapy (CT) group and interventional therapy (IT) group. In the CT group, patients received systemic chemotherapy alone; in the IT group, patients received EBUS-TBNA guided lymph node aspiration and local isoniazid injection besides systemic chemotherapy. The recovery of lymphadenitis and adverse effects were observed. Seventy patients were included for final analysis, 35 patients in each group. In the IT group, aspiration and local injection were done 137 times; 4R (53.1%) and 7 groups of lymph nodes (30.6%) were the most common site of aspiration; the median number of local treatment was 3 times, and the median duration of local injection was 29 days. The recovery rate of lymphadenitis was 88.6% (31/35) in the IT group and 57.1% (20/35) in the CT group, showing marked difference (χ2=8.741, P<0.05). The most common symptoms of patients with MTLA were cough, fever, dyspnea and anorexia, and the time to recovery of these symptoms in the IT group was 0.83±0.32, 0.89±0.29, 1.00±0.18 and 1.07±0.15 months, respectively, which were markedly shorter than in the CT group 2.60±0.74, 2.46±0.73, 2.70±0.40 and 2.67±0.43 months (t=7.608, P<0.05; t=6.442, P<0.05; t=6.755, P<0.05; t=5.237, P<0.05). All the patients received EBUS-TBNA under local anesthesia, and evident adverse effects were not observed. They were followed up for 2 years, and recurrence was not noted. As compared to systemic chemotherapy, EBUS-TBNA guided lymph node aspiration and local isoniazid injection combined with systemic chemotherapy may significantly improve the therapeutic efficacy, which provides a new, safe and reliable management for the refractory MTLA.

Leishmaniose visceral canina em Rondônia: relato de um caso autóctone

Visceral Leishmaniasis (VL), also known as kala-azar, is a disseminated protozoan infection caused by the Leishmania donovani complex. Traditionally, the definitive diagnosis is made by detecting amastigotes in biological tissue samples. In August 2015, an apparently healthy, young adult, female, mongrel dog from the Zoonosis Control Center of the Rolim de Moura,Rondônia, was subjected to the canine visceral leishmaniasis diagnosis. The diagnosis was conducted using bone marrow aspirate smears and popliteal lymph node smears by Fine-needle aspiration biopsy (FNAB); stained slides with Diff-Quick screened for Leishmania amastigotes by means of direct optical microscopic examination (100×). Lymph node and bone marrow aspirates were used to investigate the presence of Leishmania infantum chagasi DNA by real-time PCR. The popliteal lymph node positive result was observed in typical amastigotes, presenting nucleus and kinetoplasts associated with lymphoblastic proliferation, reactive macrophages, plasmocytes (commonly Mott cells), eosinophils, and lymphoglandular hyperplasia. A positive bone marrow sample resulted from the observation of amastigotes in the monocyte cytoplasm or free on the smear background. The presence of the L. infantum kDNA was detected in lymph node and bone marrow FNAB samples. This research note describes the autochthonous case of CVL recorded in the state of Rondônia, Brazil, a non-endemic area for VL. According to the data, future studies must include a larger number of animals to elucidate the parasite’s epidemiological resource in Rondônia.

With culture used as the reference standard, what is the accuracy of the Xpert® MTB/RIF assay for detecting extrapulmonary tuberculosis (TB) using cerebrospinal fluid, pleural fluid, lymph node aspirate, or urine?

With culture used as the reference standard, what is the accuracy of the Xpert® MTB/RIF assay for detecting extrapulmonary tuberculosis (TB) using cerebrospinal fluid, pleural fluid, lymph node aspirate, or urine?

ROLE OF FNAC AS A FIRST LINE INVESTIGATION TO IDENTIFY MALIGNANCIES IN CERVICAL LYMPH NODES

Lymphadenopathy is the commonest clinical presentation encountered in outpatient as well as inpatient department irrespective of age [1].FNAC is a simple, early and rapid diagnostic procedure to identify an etiology in an enlarged lymph node. Objectives of this study were to study role of FNAC in evaluating enlarged cervical lymph nodes, and to categorize malignant cases into primary and metastatic lesions. Total number of cases were 530. Out of which 477 cases were benign/infectious and 53 were malignant. The age of patients in malignant lymph node aspirates ranged from 10 year to 81 year. Out of total 53 malignant cases, 48(90.6%) cases were metastatic lesions 5 cases (9.4%) were lymphoma. Metastasis to lymph node 48 cases (90.6%) was more common than primary lymphomas 5 cases (9.4%). Present study highlights the importance of FNAC. FNAC is a simple rapid cost effective in diagnosing patients presenting with cervical lymphadenopathy. It also helps to diagnose malignancy in advanced stage patients based on the FNAC diagnosis these cases can be managed on palliative care thereby saving the patient from excision biopsy.

Optimising rapid on‐site evaluation‐assisted endobronchial ultrasound‐guided transbronchial needle aspiration of mediastinal lymph nodes: The real‐time cytopathology intervention process

Lymph node sampling by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the state of art procedure for staging the mediastinum and hilar regions in lung cancer patients. Our experience of implementing the real-time cytopathology intervention (RTCI) process for intraoperative EBUS-TBNAs is presented. This study is aimed to describe in detail the RTCI process for EBUS-TBNAs, and assess its utility and diagnostic yield before and after its implementation in parallel to conventional rapid on-site evaluation (c-ROSE). A retrospective review of all EBUS-TBNAs between July 2016 and July 2017 at the University of Rochester Medical Center was performed. Final diagnoses, patient clinical data, and number of non-diagnostic samples (NDS) were reviewed. The numbers of NDS obtained from EBUS-TBNAs with no cytology assistance (NCA), with RTCI and with c-ROSE were analysed. Non-diagnostic lymph node samples were found in 20 out of 116 (17%), three out of 114 (2.6%) and 33 out of 286 (11.5%) cases with NCA, RTCI and c-ROSE, respectively. Application of statistical analysis revealed significant difference in the NDS between the groups of cases in the operating room with NCA and RTCI (P=.005). The different settings and variables between the cases performed using RTCI in the operating room and those assisted with c-ROSE in the bronchoscopy suite preclude legitimate comparison. Our results indicate that the use of RTCI could yield a significantly low proportion of NDS when assisting EBUS-TBNA of mediastinal and hilar lymph node for lung cancer patients enhancing the diagnostic efficiency of the procedure.

What Do Hürthle Cells Mean in Thyroid Nodule Aspirates?

Clinical ThyroidologyVol. 33, No. 2 Thyroid NodulesWhat Do Hürthle Cells Mean in Thyroid Nodule Aspirates?Lisa A. OrloffLisa A. OrloffDivision of Head and Neck Surgery; Department of Otolaryngology—Head & Neck Surgery; Stanford University School of Medicine; Stanford, California, U.S.A.Search for more papers by this authorPublished Online:8 Feb 2021https://doi.org/10.1089/ct.2021;33.83-86AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetails Volume 33Issue 2Feb 2021 InformationCopyright 2021 American Thyroid Association, Inc.To cite this article:Lisa A. Orloff.What Do Hürthle Cells Mean in Thyroid Nodule Aspirates?.Clinical Thyroidology.Feb 2021.83-86.http://doi.org/10.1089/ct.2021;33.83-86Published in Volume: 33 Issue 2: February 8, 2021PDF download

Importance of eosinophilic structures and its correlation with acid fast bacilli in fine needle aspiration smears of tubercular lymphadenitis

BackgroundThe hallmark of tuberculosis in cytological smears is the presence of epithelioid cell granulomas, necrosis and AFB. In cases, where AFB not detected, diagnosis of tuberculosis can be made by ancillary tests like PCR which requires infrastructure besides being expensive. In India, where majority of population is rural-based there is an imminent need of some morphological change in cytological smears which can point towards diagnosis of tuberculosis in absence of AFB. This study was done to assess the importance of eosinophilic structures (ES) and its correlation with presence of AFB. Material & methodsThis was a retrospective study over a period of one year. Lymph node aspirates reported as granulomatous lymphadenitis, tubercular lesion or suppurative lesion were included. All smears for each case, stained with May Grunwald Giemsa (MGG), Hematoxylin and Eosin (H&E) and ZN stain were retrieved and rescreened for the presence of eosinophilic structure, necrosis, granulomas and AFB. ResultsOur study included 256 cases. Most common age group was 21–30 years with female predominance. Cervical lymph nodes were most commonly involved. In relation to ES and AFB four cytological pictures were seen i.e ES + AFB+ (44.54%) ES + AFB- (5.46%) ES- AFB+ (14.45%) ES - AFB- (35.55%). Chi square test showed a high significant statistical association between ES and AFB(p = 0.00001). ConclusionIn developing countries with very high TB prevalence like India, where new diagnostic modalities are unaffordable by rural population, presence of ES should be included as a morphological parameter in routine cytology reporting of tubercular lesions.

Xpert MTB/RIF Ultra and Xpert MTB/RIF assays for extrapulmonary tuberculosis and rifampicin resistance in adults.

Xpert MTB/RIF Ultra and Xpert MTB/RIF assays for extrapulmonary tuberculosis and rifampicin resistance in adults.

Comparative study of conventional Ziehl−Neelsen and bleach concentration method in detecting acid-fast bacilli in fine-needle aspiration material of lymph nodes

Background: Tuberculosis (TB), specific infectious disease, affects most of the organs of the human body. Extrapulmonary TB manifests commonly as lymphadenopathy. Emergence of acquired immunodeficiency syndrome warrants the rapid diagnosis to limit its spread. Aim and Objectives: The application of bleach concentration method in detecting tubercle bacilli in the material obtained by fine-needle aspiration (FNA) of lymph nodes, evaluating sensitivity of bleach concentration method over conventional direct smear method in diagnosing tubercular lymphadenitis, detecting bacilli in the background of granuloma formation. Materials and Methods: The prospective, hospital-based, cross-sectional study was carried out in a study population of 78 patients where 15 cases got eliminated following the cytological diagnosis of malignancy and inadequacy of sample. Patients with lymphadenopathy underwent FNA after clinical examination, history taking, and informed consent. The aspirated material was stained with Leishman, H and E, conventional Ziehl−Neelsen (ZN), and bleach concentration method. Data were collected and statistical analysis done. Results: The predominant age group affected was (16–30) years with male preponderance. 44.44% cases were cytomorphologically diagnosed with tuberculous lymphadenitis. Acid-fast Bacilli (AFB) was found in 23 cases by conventional ZN method and 39 cases by bleach concentration method. Sensitivity of bleach method was 92.35% compared to 54.76% in conventional ZN method. Bacilli positivity was more in cases presenting with necrosis than with granuloma alone. Conclusion: Bleach method for detecting AFB is more sensitive than conventional ZN method. It is safe, inexpensive, easy to perform, requires no additional equipment, and safe to handle in laboratory.

Visceral Leishmaniasis in Dogs

Background: Canine visceral leishmaniasis (CVL) is a zoonosis of variable clinical presentation, either in systemic or cutaneous form. Clinical signs include anorexia, ophthalmopathies, and chronic kidney disease. In the state of Santa Catarina, the foci are concentrated in the capital and its adjacencies, in the east side of the state. The objective of this study is to outline the first three reported cases of CVL in the municipality of Curitibanos, since there are no reports to date in the region of the mountainous plateau, in the middle west of Santa Catarina.Cases: All dogs were treated at the Veterinary Clinic School of the Federal University of Santa Catarina, Campus Curitibanos. The animals, two males and one female, belonged to the same tutor, resided in Curitibanos, and were attended between 2016 and 2020. In the first case, attended in 2016, the complaint was of eye and skin changes about three months ago. The animal lived in an urban environment and came from Uruguaiana, Rio Grande do Sul. On physical examination, the animal presented skin peeling, wet and crusty lesions, bloody discharge in the ears and nasal hyperkeratosis, as well as signs suggestive of uveitis. In this case, euthanasia was carried out. The second case had complaints of respiratory, eye changes, hyporexia, and polydipsia. The dog was prostrate, dehydrated, with lymphadenomegaly and respiratory disorders, compatible with bacterial pneumonia. Bilateral corneal edema confirmed uveitis. Upon return, the animal remained dehydrated with enlarged lymph nodes. In the aspiration of the lymph nodes, suggestive forms of Leishmania sp. were observed. The recommended confirmatory tests were performed, leading to a definitive diagnosis of CVL. The patient was treated with miltefosine, but later died. The third case was attended for general evaluation after a positive diagnosis for CVL during an epidemiological survey of the second case. The animal was alert, tachycardic, and tachypneic with hyperemic mucous membranes. Miltefosine-based treatment and permanent use of deltamethrin-impregnated collar were prescribed and ovariohysterectomy was carried out. The patient is clinically well. In the search for vectors, in no place or moment of search, referring to the cases, vectors for CVL were found.Discussion: It is suggested that patients 2 and 3 are autochthonous cases, whose transmission form has not been fully elucidated, and vector transmission cannot be ruled out, as well as other less common forms of transmission. For case 1, it is suggested that it is an allochthone case, probably imported from the Uruguaiana region, where the disease is endemic. The conduct of a positive result for CVL is euthanasia, with the exception of dogs that have guardians who wish to perform treatment, but not always possible due to the high cost of miltefosine, the only drug approved for dog therapy in Brazil. In the first case, the owner opted for euthanasia, since in 2016 there was no possibility of treatment. For the last two cases, a treatment cycle was performed as recommended by the guidelines. Regarding the municipality of Curitibanos, in the first case diagnosed in 2016, the animal came from Uruguaiana. In conclusion, this study aimed to report the clinical and epidemiological characteristics related to the first three patients with CVL reported in Curitibanos.

Burkholderia pseudomallei infection manifests as mediastinal/hilar lymphadenopathy: A case report

Rationale: This case report presents the diagnosis and etiology of hilar/mediastinal lymphadenopathy in a male patient.Patient concerns: A 49-year-old man presented with fever and dyspnea after physical exertion.Diagnosis: The patient was diagnosed with melioidosis by cultivation of lymph node aspirate on blood agar using the VITEK 2 compact system.Interventions: The patient was treated with ceftazidime intravenously, combined with trimethoprim/sulfamethoxazole orally for 1 week. Once the patient was discharged, he began a 12-week course of trimethoprim/sulfamethoxazole.Outcomes: The patient recovered after treatment with ceftazidime and trimethoprim/sulfamethoxazole.Conclusions: Melioidosis is an infectious disease that mainly occurs in tropical regions. It can cause severe sepsis and pneumonia, and the infection in some patients may become chronic. Endobronchial ultrasound-transbronchial needle aspiration is a useful technique in the diagnosis of patients with hilar/mediastinal lymphadenopathy.

Epidemiology of canine visceral leishmaniasis in a vulnerable region in Brazil.

Visceral leishmaniasis (VL) is a neglected and endemic zoonosis that occurs throughout Brazil; nevertheless, few studies have focused on the early detection of the disease. The municipality of Ourinhos is a non-receptive, silent and vulnerable area for VL, where the seroprevalence of this disease has so far not been investigated. The present study aimed to determine the seroprevalence of canine VL in Ourinhos-SP, and to identify the presence of risk factors. Blood samples were obtained from 604 dogs during a rabies vaccination campaign together with application of a socioeconomic questionnaire, environmental and animal characteristics and tutor's knowledge about the disease. The samples were subjected to indirect ELISA and new samples were collected from reactive and suspect animals, including whole blood and lymph node aspiration evaluated by parasitological method, complete blood count and PCR. No animal was diagnosed as positive based on the combination of direct and indirect tests and the tutors' answers indicated little knowledge about leishmaniasis, being often confused with other diseases transmitted by arthropods; hence, according to the proposed methods, the presence of canine leishmaniasis in the city of Ourinhos was not confirmed and health education campaigns about the disease should be carried out.

Prevalence and Clinicopathological Studies of Theileriosis in Goats

The present study was conducted to study the clinical profile, hemato-biochemical, post-mortem and histopathological changes of theileriosis in goat cases reported from areas in and around of Udgir city of Maharashtra state during the period from January to December 2020. Out of 107 suspected cases, 41 goats were found positive for theileriosis indicating an overall prevalence of 38.32%. The important clinical signs observed in theileriosis affected goats were fever, pale mucous membranes, swollen lymph nodes, respiratory distress and tick infestation. The hemato-biochemical abnormalities of theileriosis in goats were marked granulocytic leukocytosis, anemia, elevated levels of serum ALT, AST, BUN, creatinine and total bilirubin. The blood and lymph node aspiration smears revealed presence of pleomorphic intra-erythrocytic piroplasms and lymphoblastoid cells or macrophages with intra-cytoplasmic schizonts of Theileria spp. respectively. The characteristic post-mortem lesions of theileriosis in goats were pale or papery white mucous membranes, swollen oedematous or haemorrhagic lymph nodes, splenomegaly, punched out ulcers in abomasum and hepatomegaly with icteric discoloration. The histopathological lesions observed includes multiple haemorrhagic ulcerations and necrosis of mucosal epithelium of abomasum, proliferative changes in lymph nodes, hepatocellular degeneration and interstitial pneumonia. In conclusion, goat population in and around of Udgir city of Maharashtra state had overall prevalence of 38.32% of theileriosis by blood and lymph node aspiration smear examination.

Prevalence of Extrapulmonary Tuberculosis in Newly Registered HIV Patients

Introduction: Human Immunodeficiency Virus infection and Tuberculosis are among the ten leading causes of death worldwide. In advanced AIDS, M. tuberculosis frequently causes disseminated Extra-Pulmonary Tuberculosis (EPTB). EPTB being paucibacillary infection poses a diagnostic challenge. The emergence of Cartridge Based Nucleic Acid Amplification Test (CBNAAT) has marked an important development in the field of rapid molecular diagnostics of tuberculosis. Aims and Objective: The purpose of this study was to determine the prevalence of EPTB in newly registered HIV patients visiting ART clinic and to find the prevalence of Rifampicin resistance using CBNAAT. Materials and Method: 213 newly registered HIV patients were included in the study recruited over 10 months time period and followed up for six months from recruitment. Case record of each patient with detailed history, clinical examination and necessary blood, radiological and specimen sampling done to investigate for tuberculosis was maintained. The data obtained were analyzed using SPSS 20.0 software. Result: The prevalence of EPTB in newly registered HIV patients was found to be 14.5%, with abdomen being the most common site for EPTB. Rifampicin resistance was seen in 3.2% cases. Conclusion: The result of this study showed that the prevalence of EPTB was higher compared to PTB in HIV patients. CBNAAT sensitivity for different samples were variable. This study showed maximum sensitivity of CBNAAT for lymph node aspirate (100%) and minimum for CSF (0%). Overall the sensitivity of CBNAAT was low, yet it is a very useful investigation for detection of EPTB with high positive predictive value.

Role of GeneXpert MTB/Rif in detection of tuberculosis from clinical samples: A report from a tertiary care hospital in Mumbai

Introduction: Tuberculosis (TB) causes severe morbidity and mortality in millions of people every year, worldwide and India in particular. Hence this study was undertaken to find out the role of the widely used GeneXpertMTB/Rif test in tuberculosis detection. Materials and Methods: A total of 155 samples (pulmonary and extrapulmonary) from patients clinically suspected to have tuberculosis were received for testing by ZN (Ziehl-Neelsen) stain and GeneXpert/MTB Rif. These samples were also processed for histopathology or cytology and mycobacterial culture on request of clinician. The results were studied and compared. Result: Out of the total samples received, lymph node aspirates were 23%,pleural fluid 20%,sputum 19%,pus 10%,tissue 8%,ascitic fluid 8%,cerebrospinal fluid 7%,endometrial tissue 3%,synovial fluid 1% and urine 1%.Nine sputum samples (31%) were positive by GeneXpertMTB/Rif of which two were negative on smear, two positive on culture and there was no culture request for the remaining seven samples.29 (23%) extrapulmonary samples were positive by GeneXpertMTB/Rif out of which there was no culture request for 16 samples. One sample which was negative by GeneXpert MTB/Rif grew Atypical Mycobacteria on culture. Four isolates were detected as rifampicin resistant by GeneXpertMTB/Rif but none of them were sent for Drug Susceptibility Test (DST). Conclusion: GeneXpertMTB/Rif should be used in combination with other tests for diagnosing tuberculosis. Keywords: Drug resistant tuberculosis, GeneXpert/MTB Rif, Nucleic-acid amplification test.

A STUDY OF THE DIAGNOSTIC UTILITY OF CARTRIDGE BASED NUCLEIC ACID AMPLIFICATION TEST OF VARIOUS BODY FLUIDS OTHER THAN SPUTUM IN DIFFERENT FORMS OF TUBERCULOSIS

Introduction: Diagnosis of TB is difficult in specimens having low number of bacilli. In recent times, CBNAAT is used due to its rapidity, sensitivity and specificity The heterogeneous clinical presentations, pauci-bacillary nature and difficulty in obtaining specimens (often requiring invasive procedures) make the diagnosis of TB, a challenging task and hence the requirement for a rapid, simplified and cost effective diagnostic tool arises. Objectives: To determine the sensitivity, specificity, positive predictive value and negative predictive value of CBNAAT for diagnosis of Tuberculosis from specimens other than sputum. Methodology: Study Design-Longitudinal prospective study, Duration of Study-1 year study period, Study Setting -RNTCP Cell in the Department of Respiratory Medicine, MMCHRI, Sample Size-60, Study Population-Sputum Negative Presumptive Pulmonary and Extra pulmonary Tuberculosis Patients, Sample Collection- BAL, Pleural Fluid, Pus Aspirate, CSF, Lymph Node aspirate, Ascitic Fluid, Gastric Aspirate, Synovial Fluid. Results: In our study Majority of study population were in the age group of Less than 30(30%). About 25% were in the age group of more than 61 years. Nearly 12% were in the age group of 41-50 years. About 15% were in the age group of 31-40 years. Nearly 18% were in the age group of 51-60 years. In our study 63% were males and 37% were females. In our study 40% are smokers and 60% are nonsmokers. In our study 27% are diabetics and 73% are non-diabetics. In our study 3.4% had HIV and 96.6% are HIV negative. 10% of study population had previously taken ATT and 90% had not taken ATT. About 25% tested positive for CBNAAT test and 75% tested negative for the test. Conclusion: The diagnosis of Tuberculosis remains challenging since the number of M.tb bacilli present in tissue at the site of disease is often low and clinical specimen from deep seated organs may be difficult to obtain. CBNAAT provides an edge over other methods by reducing the time required for diagnosis and precision in detection of M.tb bacilli not only in sputum samples but also in extra-pulmonary specimens.

Spectrum of diseases presenting with lymphadenopathy in elderly: Fine needle aspiration cytology of 60 cases

Introduction: Lymphadenopathy is one of the common clinical presentations in patients of all age group. Lymphadenopathy can be due to reactive or infective cause, but malignancy including metastastic deposits in are not uncommon in elderly. Fine needle aspiration cytology (FNAC) is a useful diagnostic rapider in many mass lesions like lymphadenopathy. Aims and Objectives: Three years study was conducted to know the spectrum of diseases causing enlargement of lymph nodes in elderly patients with age 60 years and above. Materials and Methods: We have collected all the clinical data from the registers from June 2014 to June 2017 in Medical records section, KIMS, Koppal and reviewed FNAC slides of lymph node aspirates of elderly. Results: A total of 60 elderly patients of age 60 years and above with lymphadenopathy were included in this study. Cervical group of lymph nodes were the predominant site for lymphadenopathy. The commonest cause of lymphadenopathy was reactive, seen in 29 patients, followed by 23 patients with metastatic deposits and squamous cell differentiation was commonest type. Tubercular and suppurative lymphadenitis were observed in four cases each. CBNNAT is an useful diagnostic modality in microbiological confirmation of tuberculosis. Males showed preponderance of reactive as well as in metastatic lymphadenopathy. Conclusion: Though reactive lymphadenitis is the commonest cause for enlargement of lymph nodes but metastatic deposits are not uncommon in elderly. FNAC as a diagnostic rapider useful screening tool for all elderly patients presenting with lymphadenopathy. Keywords: Lymphadenopathy, Reactive, Metastatic, FNAC, Tubercular, CBNAAT.

Isolation, Molecular Typing, and Antibiotic Susceptibility Testing of Mycobacterium avium Subspecies hominissuis From a Dog With Generalized Mycobacteriosis.

Mycobacterium avium-intracellulare complex infections are becoming an increasing concern in veterinary medicine because they affect livestock, wildlife, and companion animals. Here we describe the isolation, molecular typing, and antibiotic susceptibility testing of the causative agent of a rare case of generalized mycobacteriosis in a crossbred dog. Mycobacterial colonies were isolated from a popliteal lymph node aspirate sample and molecular typed by SNPs typing of the genes gyrB and rpsA, the 3′ region of the hsp65 gene and the internal transcribed spacer (ITS), and MIRU-VNTR analysis. Colonies were also tested in vitro against the macrolide clarithromycin and other drugs, using a resazurin microdilution assay, in order to provide the most appropriate treatment for the dog. Results from SNPs typing of gyrB and ITS, as well as from MIRU-VNTR analysis suggested the isolation of a single strain of M. avium subsp. hominissuis (Mah). On the other hand, SNP typing of rpsA revealed DNA polymorphisms that led colonies to cluster into two groups. The presence of two distinct strains of Mah has been assumed. All colonies, regardless of the nucleotide sequence of rpsA, were found to be sensitive to all of the drugs tested except for ethambutol. Although the therapy administered was adequate, the dog's overall clinical status worsened progressively and the animal died 8 months later. In conclusion, we report on the isolation of Mah from a dog with generalized mycobacteriosis.

Variation of apoptotic and proliferative activity among lymphoma subtypes in dogs: A flow cytometric study

Tumor growth depends on both proliferative and apoptotic rate of neoplastic cells. High proliferation index is a well-known negative prognostic factor in canine lymphomas, whereas little is known about apoptotic activity. We describe proliferative and apoptotic rates in different canine lymphoma subtypes at diagnosis. Flow cytometry (FC) was used to assess the percentage of proliferating cells (Ki67%) and of apoptotic cells (AnnV%) in 128 lymph node (LN) aspirates from dogs with lymphoma. Proliferation/apoptosis ratio (PAR) and turnover index (TI; Ki67% + AnnV%) were then calculated for each case.High-grade B-cell lymphomas showed high values for both Ki67% and AnnV%, low-grade B-cell lymphomas showed low Ki67% and high AnnV%, high-grade T-cell lymphomas showed high Ki67% and low AnnV%, and low-grade T-cell lymphomas showed low levels of both parameters. Lymphoblastic lymphomas had the highest PAR values. High-grade B-cell lymphomas had the highest TI values while small clear cells lymphomas the lowest.The panorama of proliferative and apoptotic activity widely varies among lymphoma subtypes. Our results lay the ground for future clinical and pharmacological studies.

Current issues relating to diagnostics and treatment of papillary thyroid cancer with coexistent autoimmune thyroiditis

Recent studies have shown that papillary thyroid cancer (PTC) associated with autoimmune thyroiditis (AIT) has a higher percentage of malignant nodes. However, it has not been studied how AIT affects the development and course of PTC.The aim was to determine the incidence of autoimmune thyroiditis in papillary thyroid cancer and study the frequency of its metastasis.Materials and methods. A retrospective analysis of 63 case histories of patients diagnosed with PTC who received treatment in the Surgery Department of “VIZUS” LLC from January 2018 to December 2019 was performed. The mean age of the patients was 53.1 ± 10.4 years. There were 56 (88.9 %) women and 7 (11.1 %) men among the patients. All the patients underwent surgical treatment. An inclusion criterion for the main group was pathohistologically confirmed PTC and AIT – 33 patients (52.4 %). The comparison group included patients with PTC without AIT – 30 (47.6 %).Results. Hypothyroidism was detected in 5 (15.2 %) persons of the main group, and the other patients were diagnosed with euthyroidism – 28 (84.8 %). All the comparison group patients - 30 (100 %) were in a state of euthyroidism. Elevation of antibodies to thyroperoxidase (AT-TPO) was found in 14 (42.4 %) persons in the main group, while no increase in this indicator was found among the comparison group patients. The specific to AIT changes in the ultrasonographic characteristics of the thyroid parenchyma were detected in 13 patients (39.4 %) of the main group and in 9 (30.0 %) patients of the comparison group, P = 0.3714. Following the cytological examination results of thyroid nodule aspirates, follicular neoplasia was detected in 6 (18.2 %) patients of the main group and in 2 (6.7 %) of the comparison group, P = 0.0473. The pathohistological examination revealed a combination of PTC with AIT in 33 (52.4 %) patients. Cancer metastasis to the regional lymph nodes was observed in 14 (42.4 %) patients with AIT and 10 (33.3 %) patients of the comparison group, P &lt; 0.0356.Conclusions. The results of ultrasound, fine-needle aspiration biopsy and measurement of serum thyroid hormone levels are not sufficiently informative to diagnose AIT. The specific to AIT changes in the thyroid parenchyma impede the diagnosis of malignancies. The metastasis frequency in PTC with coexistent AIT is higher than without it.