Tuberculous Lesions Research Articles

Spontaneous Tuberculosis Cases In Two Pigeon Flocks

In this study, a 2-year-old female rock pigeon and two 4-month-old tumbler domestic pigeon brought to Erciyes University, Faculty of Veterinary Medicine, Department of Pathology, for necropsy were diagnosed as tuberculosis. On the macroscopic examination, several nodules with yellowish colour were seen in the pulmonary sections as well as in the rock pigeon. The grey-yellowish nodules were found on the right wings (1 x 1.5 x 0.8 cm in size), the liver surface and the jejunum in the small intestine (with a size ranging from 0.5-1 mm to 1 cm) and near the craw (0.3 x 0.8 cm in size) of the one tumbler pigeon. In other, grey-yellowish nodular structures were seen in the lungs 1 x 1.2 x 0.5 cm and 0.5 x 0.7 x 0.6 cm in the liver. Histopathological examination showed that these lesions were tuberculous lesions consisting of homogeneous eosinophilic colourized casein necrosis, surrounding multi-nucleated giant cells, epithelioid histiocytes, histiocytes, lymphocytes and, most extensively, typical tubercles with a fibrous capsule. According to In the Ziehl-Neelsen staining, tuberculous bacillus was not observed in the tissue of rock pigeon, while tuberculous bacillus was found in a large number of dense red in tubercle structures in both of the tumbler pigeons. Because of the zoonotic nature of the agent and the risk of contamination, it was evaluated as a case report.

Sequential Endoscopic Findings of a Tuberculous Esophageal Ulcer that Developed into a Traction Diverticulum

Esophageal diverticula are uncommon lesions that are usually classified according to location, layers of the wall, and underlying pathogenesis. A true traction esophageal diverticulum, which is commonly seen in the middle one-third of the thoracic esophagus, occurs secondary to mediastinal inflammatory lesions, such as those caused by tuberculosis. Esophageal tuberculosis usually develops secondary to tuberculous lymphadenitis or lung lesion; it manifests with various endoscopic findings such as single or multiple ulcers, elevated lesions with ulcers at the center, extrinsic compressions, fistulas, and rarely, anthracosis. Its shape can vary greatly depending on disease progression and treatment. Herein, we report sequential endoscopic findings of a tuberculous esophageal ulcer that turned into a depressed lesion with black-pigmentation, finally developing into a typical traction esophageal diverticulum in a patient with mediastinal lymphadenitis.

Management of intracranial tuberculous mass lesions: how long should we treat for?

Tuberculous intracranial mass lesions are common in settings with high tuberculosis (TB) incidence and HIV prevalence. The diagnosis of such lesions, which include tuberculoma and tuberculous abscesses, is often presumptive and based on radiological features, supportive evidence of TB elsewhere and response to TB treatment. However, the treatment response is unpredictable, with lesions frequently enlarging paradoxically or persisting for many years despite appropriate TB treatment and corticosteroid therapy. Most international guidelines recommend a 9-12 month course of TB treatment for central nervous system TB when the infecting Mycobacterium tuberculosis ( M.tb) strain is sensitive to first-line drugs. However, there is variation in opinion and practice with respect to the duration of TB treatment in patients with tuberculomas or tuberculous abscesses. A major reason for this is the lack of prospective clinical trial evidence. Some experts suggest continuing treatment until radiological resolution of enhancing lesions has been achieved, but this may unnecessarily expose patients to prolonged periods of potentially toxic drugs. It is currently unknown whether persistent radiological enhancement of intracranial tuberculomas after 9-12 months of treatment represents active disease, inflammatory response in a sterilized lesion or merely revascularization. The consequences of stopping TB treatment prior to resolution of lesional enhancement have rarely been explored. These important issues were discussed at the 3 rd International Tuberculous Meningitis Consortium meeting. Most clinicians were of the opinion that continued enhancement does not necessarily represent treatment failure and that prolonged TB therapy was not warranted in patients presumably infected with M.tb strains susceptible to first-line drugs. In this manuscript we highlight current medical treatment practices, benefits and disadvantages of different TB treatment durations and the need for evidence-based guidelines regarding the treatment duration of patients with intracranial tuberculous mass lesions.

Differentiation of Intraspinal Tuberculosis and Metastatic Cancer Using Magnetic Resonance Imaging.

PurposeThis study aimed to explore the differences in the magnetic resonance imaging (MRI) findings between intraspinal tuberculosis and metastatic cancer, which may aid in making the correct diagnosis.Patients and MethodsThe clinical features and MRI findings of 15 patients with intraspinal tuberculosis and 11 patients with intraspinal metastatic cancers were retrospectively analyzed.ResultsThe mean ages of the patients with intraspinal tuberculosis and metastatic cancer were 26.3 (15–42) and 52.1 (38–67) years, respectively. All intraspinal tuberculosis cases were secondary to primary extraspinal tuberculosis, including tuberculous meningitis (11/15), as well as pulmonary (9/15), vertebral (5/15), urinary tract (1/15), abdominal (1/15), cervical lymph node (1/15), and multisystem tuberculosis (9/15). The intraspinal metastases originated from the breast (5/11), lung (3/11), kidney (1/11), ovarian (1/11), and nasopharyngeal cancers (1/11). Both intraspinal tuberculosis and metastatic cancers presented with multiple intra- and extramedullary lesions throughout all regional segments of the spinal canal, accompanied by irregularly thickened meninges. Intraspinal tuberculous lesions had indistinct edges that integrated with each other, most of them exhibiting obvious enhancement on MRI. Conversely, intraspinal metastatic lesions were distinctly separated with clear edges and exhibited lesser enhanced MRI than intraspinal tuberculosis.ConclusionA combined analysis of clinical features and MRI findings may be helpful in differentiating intraspinal tuberculosis from metastatic cancer.

Патоморфологічна характеристика інтестинальних патологій за генералізованого туберкульозу фазанів

The results of a pathomorphological study of intestinal wall of pheasants with tuberculosis were discussed. The object of the study were intestines of pheasants (n=5) which died from generalized tuberculosis. The aim of the study was to describe  and classify pathological changes in the intestinal wall of pheasants with tuberculosis. Materials and research methods. The work was carried out at the department of normal and pathological morphology of KhSZVA. Methods of postmortem autopsy of birds with partial evisceration, macroscopic analysis of the condition of the intestinal wall, pathological examination of its samples, microscopy according to Zichl-Neelsen for the detection of acid-resistant mycobacteria, PCR were used. Result of the research. We revealed tuberculous lesions with varying degrees of intensity and complexity in the intestinal wall of pheasants. Mycobacterium tuberculosis (stick-shaped red colored microorganisms) detected in smears-prints intestine walls altered fragments using Zichl-Neelsen bacterioscopy. Final diagnosis “Tuberculosis of birds” was established based on macroscopic data, histopathological studies of the intestinal wall, Zichl-Neelsen bacterioscopy, PCR results. Tuberculous granulomas of alternative type predominated in the intestinal wall of pheasants. Proliferative granulomas were rarely detected. The complex of post-tuberculous reparative processes and indicators due to them was classified. In the intestinal wall created alterative type of ulceri with perifocal fibrosis as a result of degradation of tuberculosis granulomas. Scarring of ulcerative areas, local edema, abscess-like wall formations, strictures, partial obstruction of intestines were detected. Mixed forms of tuberculous intestinal lesions: nodular-ulcerative, including, with scarring and stenosis; nodular, including drain, with extra- and intramural abscess-like formations were diagnosed in four pheasants. Nodular monoform of intestinal lesions was classified in one pheasant.

Chromoblastomycosis: A rare fungal infection from a nonendemic region—Southern Odisha

Chromoblastomycosis, a slowly progressing localized fungal infection confined to the skin and subcutaneous tissue, is caused by dematiaceous fungi. Dermal lesions are pleomorphic and can range from small nodules to large papillary like eruptions. Herein, we report a case of chromoblastomycosis in a 26-year-old male caused by Fonsecaea pedrosoi. The patient was immunocompetent and had thorn injury 4 years back and developed a nonhealing ulcer on the medial aspect of his right leg, which was clinically suspected as tuberculous or carcinomatous lesion. Punch biopsy was done and sent in normal saline for the histopathological examination. Microscopically, sclerotic bodies, characteristic of chromoblastomycosis, were noticed on hematoxylin and eosin stained sections. Potassium hydroxide mount of the punch biopsy also revealed dematiaceous branching septate fungal hyphae. The fungal culture produced typical black colonies of Fonsecaea pedrosoi. The case is of interest because to the best of our knowledge it has so far not been reported from our region—southern part of Odisha.

Epidemiological Study on Bovine Tuberculosis in Boran Breeds Cattle at Yabello District, Southern, Ethiopia

A cross-sectional study was conducted at Yabello district, Southern Ethiopia from December 2009 to April 2010 with the aim of an epidemiological survey of Bovine tuberculosis through different diagnostic approach Comparative Intradermal Tuberculin test (CIDT), Questionnaire survey, Abattoir inspection, Bacteriological, and Histopathological examination on animals presenting in the study area. A retrospective study of human TB cases recorded at Yabello Hospital over a six-year (2004-2009) period was also analyzed to determine the significance of the extrapulmonary tuberculosis (EPTB) form of human TB in the district. During the study period, 790 heads of local Boran breed cattle were included among which 540 heads of cattle were subjected for the CIDT test, while the remaining 250 heads were subjected only for abattoir inspection. The prevalence of gross tuberculous lesion positive samples was 16.4%. These samples were again collected for Ziehl Neelsen acid-fast stain and histopathological examination. The result of Ziehl Neelsen acid-fast stain has indicated that, 19.5% positive and 80.5% negative. There was a statistically significant association between the occurrence of the lesions and body condition score (BCS) (χ²=10.903, P=0.006). On the other hand, the result of the CIDT test has revealed 1.3% positive, 7.2% suspected, and 91.5% negative. All selected traits (sex, Age. BCS, and origin of the animal) measured with the PPD test did not show a statistically significant difference among the categories (p>0.05). Besides, a questionnaire survey conducted on 23 households of animal owners indicated that 95.7% had the habit of raw milk consumption. A retrospective study of human TB cases recorded for six years revealed that there was a 13.76% proportion of EPTB forms. The prevalence of BTB in the study area is slightly high when compared with the previous study. However, it needs further investigation and surveillance to explore the control and prevention methods of BTB and its zoonotic importance which requires the awareness of the population on the management of the disease and associated risk factors.

Primary Tuberculous Mastitis

Background: Tuberculous mastitis is a rare entity in patients with mammary diseaseeven in countries where incidence of tuberculosis is high. In Bangladesh, TB is anendemic disease but breast tuberculosis is rarely reported. Its clinical patterns andtreatment strategies are changing day by day.
 Objective: To analyze the clinical presentations , diagnosis and treatment of tuberculousmastitis
 Methods: This is a prospective nonrandomized descriptive study to analyze clinicalpresentations, diagnosis and treatment of hundred (100) cases received care for tuberculousmastitis at the Chest Disease Hospital, Rajshahi, from July' 2012 to July' 2016.Diagnosis was made in all patients by cytological examination from suspected lesions,which revealed typical tuberculous lesions. Patient with some atypical presentationsand doubts in the diagnosis needed histopathological examination and Gene x-pert testto exclude idiopathic granulomatous mastitis and concomitant malignancy.
 Results: Most of the patients were within reproductive age. The disease affecting theright breast in fifty six patients (56%), left breast in forty three patients (43%) andbilateral in one patient (1%). Palpable lump were present in eighteen patients (18%),chronic discharging sinus with or without lump in thirty four (34%) and breast abscesswith or without discharging sinus in eighteen patients (18%),recent abscess drainagescar with lump in thirty patients(30).Medical therapy with anti-tubercular drugs ranging from 9 to 12 months with follow upmonthly was the mainstay of treatment. Surgical intervention reserved for selectedrefractory cases. Extension of anti-tubercular therapy from 9 to 12 or 18 monthsrequired in fifty-eight(58) patients on the basis of slow clinical response. Completeresolution obtained in 92 patients but residual tiny mass in eight patients confirmed byrepeated FNAC to be fibrotic.
 Conclusion: Treatment is simple but high index of suspicion is the cornerstone fordiagnosis.
 Journal of Surgical Sciences (2017) Vol. 21 (1) :19-23

A combined measure of tuberculous lesions for assessing the efficacy of vaccination against tuberculosis (Mycobacterium bovis) in European badgers (Meles meles) supports the 3Rs principle of reduction

BackgroundAn oral vaccine is a potential tool to tackle the reservoir of Mycobacterium bovis in European badgers (Meles meles), which contributes to tuberculosis of cattle in the British Isles. Inferences about vaccine protection against experimental challenge with M. bovis depend on the measurement of tuberculosis. Assessment of tuberculosis in larger species, such as badgers, is typically based on the tuberculous lesions visible at post-mortem examination and histopathology. We have developed a robust scoring system for tuberculous lesions by combining several parallel measures, which we call the “disease burden score” (DBS). MethodsAlternative scoring systems were compared within a regression analysis applied to observations from a total of 168 badgers from eight studies, including 107 badgers subjected to vaccination treatment and 61 non-vaccinated controls. The analysis included incidental observations that were recorded from each badger as potential covariate factors explaining some of the variation among animals sourced from the wild. ResultsDBS was found to be the most accurate and reliable of the scoring systems compared. By taking account of significant covariates affecting disease, application of the DBS reduced residual variance by 22.9%. A previously used measure, based on assessment of visible lesions, was suboptimal due to non-uniform variance that increased with expected value, although square root transformation addressed this issue. The covariate model fitted to DBS included sex (males had higher DBS), weight (negatively associated with DBS) and immunological evidence of prior exposure to Mycobacterium avium (positively associated with DBS). ConclusionsWe identified improved measures of tuberculous disease derived from data already collected. We also demonstrated that the proper scaling of measurements of disease in such models is necessary and can be determined empirically. The covariates which were most strongly associated with the severity of disease are important in experimental studies involving outbred animals with variable background.

Management of intracranial tuberculous mass lesions: how long should we treat for?

Tuberculous intracranial mass lesions are common in settings with high tuberculosis (TB) incidence and HIV prevalence. The diagnosis of such lesions, which include tuberculoma and tuberculous abscesses, is often presumptive and based on radiological features, supportive evidence of TB elsewhere and response to TB treatment. However, the treatment response is unpredictable, with lesions frequently enlarging paradoxically or persisting for many years despite appropriate TB treatment and corticosteroid therapy. Most international guidelines recommend a 9-12 month course of TB treatment for central nervous system TB when the infecting Mycobacterium tuberculosis ( M.tb) strain is sensitive to first-line drugs. However, there is variation in opinion and practice with respect to the duration of TB treatment in patients with tuberculomas or tuberculous abscesses. A major reason for this is the lack of prospective clinical trial evidence. Some experts suggest continuing treatment until radiological resolution of enhancing lesions has been achieved, but this may unnecessarily expose patients to prolonged periods of potentially toxic drugs. It is currently unknown whether persistent radiological enhancement of intracranial tuberculomas after 9-12 months of treatment represents active disease, inflammatory response in a sterilized lesion or merely revascularization. The consequences of stopping TB treatment prior to resolution of lesional enhancement have rarely been explored. These important issues were discussed at the 3 rd International Tuberculous Meningitis Consortium meeting. Most clinicians were of the opinion that continued enhancement does not necessarily represent treatment failure and that prolonged TB therapy was not warranted in patients presumably infected with M.tb strains susceptible to first-line drugs. In this manuscript we highlight current medical treatment practices, benefits and disadvantages of different TB treatment durations and the need for evidence-based guidelines regarding the treatment duration of patients with intracranial tuberculous mass lesions.

Tuberculosis and HIV co-infection in inpatients of phthisio-pulmonological profile: frequency, form of lesion, diagnostic features (according to data of highly specialized institution)

Objective — to clarify the prevalence of tuberculosis infection in HIV-positive inpatients of the TB hospital for 2014—2018 and features of its diagnosis in the affection of the chest cavity organs.Materials and methods. The method of retrospective analysis was used to process medical records of the Institute’s clinic for the period 2014—2018. A database has been formed that includes all patients with HIV infection treated in the hospital, from which a group of patients with a final clinical diagnosis of co-infection tuberculosis and HIV was subsequently selected.Among them were 195 (68.9 %) men and 88 (31.1 %) women. The average age of men was (37.0 ± 0.5), women — (38.0 ± 1.2) years. Separate subgroups of patients were selected, taking into account the localization of the tuberculous process in the chest cavity. The general clinical data of patients, the presence of comorbidities, diagnostic methods, localization and prevalence of the tuberculous process were taken into account.Results and discussion. Among 496 hospitalized HIV-positive patients with various pathologies of the chest cavity, the diagnosis of tuberculosis, that is, the presence of HIV-TB co-infection, was established in 283 (57.1 %) cases. In 46 (16.3 %) cases the diagnosis of HIV infection was established for the first time during hospitalization. Comorbid pathology was present in 184 (65.0 %) patients.Specific lung damage prevailed, 123 (44 %) cases, most often infiltrative tuberculosis (48.8 %). In 33 % of cases, there was a widespread tuberculous lesion — pulmonary and extrapulmonary (pleura or lymph nodes were involved). Isolated pleural lesion was diagnosed in 13 % of cases. The main methods of laboratory diagnostics were classical bacteriological methods — simple direct light microscopy and MBT culture, the positive results of which were obtained in only half of all studies, as well as molecular-genotypic tests. Prevalence of multidrug-resistant MBT strains was found (66.7 %).In about half of the cases, (44.9 %), additional mini-invasive procedures or surgical interventions with therapeutic and diagnostic purposes were performed. Histological examination confirmed the diagnosis of tuberculosis in 92 % of cases, whereas in the absence of signs of tuberculosis, diagnoses of other opportunistic diseases were most often specified/established.Conclusions. In HIV-positive inpatients of a phthisiopulmonary profile, tuberculosis infection prevails in the structure of opportunistic morbidity, 57.1 %. The largest proportion of patients consist cases with pulmonary tuberculosis (44 %), is also a large group (33 %), formed by patients with the extended lesion of the organs of the chest cavity.Positive results of traditional bacteriological studies were obtained in approximately half of the cases, which required an expansion of the diagnostic algorithm with the implementation of mini-invasive diagnostic procedures with biopsy of the affected tissues and subsequent histological examination.Analysis of the results of laboratory diagnostics of tuberculosis in cases of TB/HIV co-infection showed that the use of not only different microbiological research methods is most effective, but an important component in the diagnostic search is the histological examination of biopsy material.

Management of intracranial tuberculous mass lesions: how long should we treat for?

Tuberculous intracranial mass lesions are common in settings with high tuberculosis (TB) incidence and HIV prevalence. The diagnosis of such lesions, which include tuberculoma and tuberculous abscesses, is often presumptive and based on radiological features, supportive evidence of TB elsewhere and response to TB treatment. However, the treatment response is unpredictable, with lesions frequently enlarging paradoxically or persisting for many years despite appropriate TB treatment and corticosteroid therapy. Most international guidelines recommend a 9-12 month course of TB treatment for central nervous system TB when the infectingMycobacterium tuberculosis(M.tb) strain is sensitive to first-line drugs. However, there is variation in opinion and practice with respect to the duration of TB treatment in patients with tuberculomas or tuberculous abscesses. A major reason for this is the lack of prospective clinical trial evidence. Some experts suggest continuing treatment until radiological resolution of enhancing lesions has been achieved, but this may unnecessarily expose patients to prolonged periods of potentially toxic drugs. It is currently unknown whether persistent radiological enhancement of intracranial tuberculomas after 9-12 months of treatment represents active disease, inflammatory response in a sterilized lesion or merely revascularization. The consequences of stopping TB treatment prior to resolution of lesional enhancement have rarely been explored. These important issues were discussed at the 3rdInternational Tuberculous Meningitis Consortium meeting. Most clinicians were of the opinion that continued enhancement does not necessarily represent treatment failure and that prolonged TB therapy was not warranted in patients presumably infected withM.tbstrains susceptible to first-line drugs. In this manuscript we highlight current medical treatment practices, benefits and disadvantages of different TB treatment durations and the need for evidence-based guidelines regarding the treatment duration of patients with intracranial tuberculous mass lesions.

Tuberculosis as a socially significant disease. The organization of medical care for patients with tuberculosis in Khanty-Mansiysk Autonomous District – Ugra

Introduction. In the world (and in the Russian Federation) the situation caused by the increase in the number of socially significant diseases continues to be quite tense. The most important in this group is tuberculosis, which causes significant damage to society, due to the loss of temporary and permanent disability, an increase in the number of disabled people and destabilization of the demographic situation in the country. In this regard, an integrated approach to the implementation of therapeutic and preventive measures in patients suffering from tuberculous lesions is a priority in addressing the spread of this pathology. Purpose of the study. Analysis of data on the epidemiological situation, morbidity, prevalence, mortality, prevention and treatment of tuberculosis patients in the Khanty-Mansiysk Autonomous District – Ugra in 2017, comparing the figures for the first half of 2017 and 2018. Materials and methods. To assess the parameters characterizing the organization of early diagnosis of tuberculosis, hospitalization of patients of the relevant cohort of the population, the effectiveness of therapeutic measures taken, the quality of preventive measures among the population of the Khanty-Mansiysk Autonomous District – Ugra, the data of annual reports of relevant medical organizations for 2017–2018 are used. Results. In 2017, the coverage of examinations for tuberculosis of the population with the use of all survey methods amounted to 78,6%, while the target indicator of the state program «Health Development 2014–2020» was 78,0%. The number of patients effectively treated at the studied stages was more than 50% of cases for each. Conclusion. In the Autonomous District – Ugra, the work of all services and institutions for the treatment and prevention of tuberculosis is recognized as systematic and effective according to the results of events held.

The Possibilities of Bronchoscopy and Endosonography in the Differential Diagnosis of Mediastinal Tuberculous and Metastatic Lesions

This clinical case shows the experience in concurrently using video-assisted bronchoscopy and endosonography in a patient with mediastinal adenopathy for differential diagnosis between tuberculous and metastatic changes. It demonstrates the possibilities and limitations of using both classical bronchoscopy and transesophageal endosonography with a EUS-b-FNA using echobronchoscope.

Seroprevalence and molecular characterization of Mycobacterium bovis infection in camels (Camelus dromedarius) in the Delta region, Egypt.

Aim:This study aimed to determine the prevalence rates of Mycobacterium infection in camel sera collected before slaughter and gross lesion tissue collected postmortem (PM) using enzyme-linked immunosorbent assay (ELISA), bacteriological culture, and polymerase chain reaction (PCR). In addition, serum samples from humans who had occupational contact with camels were tested by ELISA and sputum sample by culture.Materials and Methods:ELISA was performed on serum samples antemortem. In addition, bacteriological culture and PCR were conducted after PM. Tuberculosis infection was identified in humans who had contact with camels using ELISA for serum samples and culture for sputum samples.Results:Tuberculous lesions were detected in 184 of 10,903 camels (1.7%). The ELISA results revealed that of the 184 examined camel serum samples, 124 (67.39%) were positive and all 20 camel serum samples that had no associated tuberculous lesions were negative. Moreover, only one of 48 (2.08%) human serum samples was positive by ELISA. Mycobacterial culture revealed 112 isolates from the 184 examined camel samples (60.87%), while human sputum sample cultures were all negative. PCR analysis identified the mpb70 gene in three of seven randomly tested samples.Conclusion:Gene sequencing was performed on two samples and the sequences were submitted to the National Center for Biotechnology Information GenBank (accession numbers MF990289 and MG59479). A phylogenetic tree was constructed based on the partial DNA sequences of the mpb70 gene; the similarity between the isolates was 98.1%. The similarities between the two isolates and the standard strains of Mycobacterium bovis in GenBank were 98.1% and 100%, respectively. Further investigation on the antemortem detection of M. bovis infection in camels is needed to decrease public risk.

Prevalence and Economic Losses Due to Bovine Tuberculosis in Cattle Slaughtered at Bodija Municipal Abattoir, Ibadan, Nigeria

Abstract Bovine tuberculosis (BTB) is a zoonotic disease responsible for considerable economic losses; with consequent negative impact on both public health and the livestock industry. However, the burden of this disease and associated economic losses remain un-investigated among slaughtered cattle in Ibadan, the hub of livestock activities in south-western Nigeria. A cross sectional study was conducted over a three-month period to determine the prevalence and economic losses due to BTB among slaughtered cattle at the Bodija Municipal Abattoir, Ibadan, in south-western Nigeria. Individual slaughtered cattle were purposively inspected for the presence of tuberculous lesions, and representative sample of affected organs and associated lymph nodes from the BTB suspected animals were taken. The suspected lesions were processed based on Becton Dickinson digestion and decontamination procedure and the losses due to BTB were estimated mathematically, using a formula. The BTB prevalence of 9.3 % (38/408) was obtained with a significant statistical association (P ≤ 0.05) of the disease with the breeds of cattle slaughtered. Out of the 46 visceral organs condemned: 29 (63 %) were lungs, 12 (26.1 %) livers, 4 (8.7 %) hearts and 1 (2.2 %) kidney. The total estimated annual economic loss (direct and indirect) due to BTB was estimated as Nigerian naria NGN 703,980,070 (EUR 1,725,441.4). This study revealed BTB as endemic and a major cause of concern considering its ill-health and economic effects on both humans and the livestock industry. Efforts are therefore required: to control this disease along the beef value chain in order to safeguard human and livestock health; as well as to limit the economic losses associated with its prevalence.

EVALUATION OF PRIMARY EXTRANODAL NON-HODGKIN LYMPHOMA: A RECORD BASE STUDY

INTRODUCTION: Lesions in head and neck have always been a diagnostic dilemma for a pathologist and a treating clinician. Being on the exposed part of body, they become cosmetically unacceptable. These include lesions arising from the regional group of lymph nodes. Most commonly lymphadenopathy is a common clinical presentation. The diagnostic probability ranges from infections to developmental abnormalities, from inflammatory to malignant lesions. None the less all the lesions in lymph nodes of the head and neck region cannot be limited to a particular age group and gender. Routine staining procedures like PAP, Giemsa, Field and even H & E has been used to clinch the pathogenesis of the lesion. It can be said without any fear of contradiction that FNAC is certainly a very important tool for an early diagnosis of not only head and neck lesions but also other lesions elsewhere in the body.
 MATERIAL AND METHODS: This is a comparative study which was conducted in the department of pathology. The patients were subjected to detailed history and thorough clinical examination according to the working proforma. Patients were subjected to FNAC after written informed concent. The slides were stained using PAP, Giemsa and H&E stain and examined for underlying pathology. A detailed gross examination was done and 3-15 sections were selected from the representative areas for routine paraffin sections.
 RESULTS: Amongst the total of 296 patients aspirated, 127 were from Lymph Nodes of head and neck region. Cervicallymph nodes were the most common group of lymph nodes aspirated, followed by submandibular and submental lymph nodes. Age wise tabulation shows maximum frequency of inflammatory lesions at younger age, of which reactive hyperplasia was more common in pediatric age group and tuberculous lesions were more common in 20-40years of age.
 CONCLUSION: Cervical lymph nodes were the most common group of lymph nodes aspirated, followed by submandibular and submental lymph nodes. Reactive lymphadenitis is the most frequent diagnosis amongst the lymph node lesions and tuberculous lesions was the second most common diagnosis amongst all the lymph node lesions. 35 cases out of 127, as tuberculous lymphadenitis. Histopathology correlation could be done in 36 cases, of which 32 were found be correctly diagnosed in cytology.

Rare Case of Spinal Tuberculosis Mimicking Disseminated Malignant Disease in a 9-Year-Old Boy

Purpose Musculoskeletal tuberculosis in children is a rare disease that most commonly affects the spine. Young children living in areas with high disease prevalence are at increased risk of developing tuberculosis. With this case report, we aim to emphasize the high degree of suspicion one must have in diagnosing pathological fracture of vertebrae including disseminated malignant disease and multiple tuberculous spondylitis lesions in differential diagnosis.

ЛУЧЕВАЯ СЕМИОТИКА ТУБЕРКУЛЕЗНОГО ПОРАЖЕНИЯ ГРУДИНЫ И РЕБЕР У ДЕТЕЙ

The objective of the study : to identify specific features of tuberculosis of the sternum and ribs in children using data of CT scans. Subjects and methods . 16 children at the age from 1 to 8 years old with bacteriologically confirmed tuberculous ostitis of the sternum or ribs or perichondritis of the ribs were followed up; from 2013 to 2015, all of them had surgery in the pediatric surgical clinic of St. Petersburg Research Institute of Phthisiopulmonology. The scans of their computed tomographies performed not earlier than 2 weeks before the surgery were analyzed. Results of the study . Tuberculous ostitis of the sternum and ribs in children is usually characterized by the presence of an extensive destructive cavity with the destruction of the cortical layer and dissemination into soft tissues (clinical examples are given). Sclerosis, swelling of the bone in the affected area, free bone sequestration in the destructive cavity and surrounding soft tissues, described in the literature as typical signs of tuberculous bone lesions, are not often found in tuberculous ostitis of the sternum and ribs in children.

Diagnosis of bovine tuberculosis by immunohistochemistry and polymerase chain reaction–restriction fragment length poly-morphism

Bovine tuberculosis is a chronic, contagious, granulomatous disease of domestic as well as wild animals, caused by the member of Mycobacterium tuberculosis complex. The present study was carried out to diagnose bovine tuberculosis using Ziehl-Neelsen Staining, Histopathology, Immunohistochemistry and Polymerase Chain Reaction-Restriction Fragment Length Polymorphism. Twenty lung samples from animals suspected for tuberculosis were collected for the study. Grossly, circumscribed yellowish white calcified lesions of various sizes were observed and acid-fast bacilli were revealed in thirteen impression smears. Histopathologi- cally, the lung section showed tuberculous granulomatous lesions characterised by well-demarcated, multifocal areas of caseous necrosis with calcification and circumscribed fibrous encapsulation along with mononuclear cells. Immunohistochemically, Mycobacterium tuberculosis antigens were detected in the eleven lung granulomas and thereby diagnosed as bovine tuberculosis. Further the causative agent was confirmed as M. bovis by PCR-RFLP.