Hello everyone, its been 1 week i guess i didn't post anything as i was busy with my work and seminars i don't have enough time to post.
I finished my seminar today and now i got a bit relief now. Today i would like to share one case that i have seen. This is an important one why because we have listened and seen these type of cases before. Lets see the case.
CASE
A 22 year female patient came with complain of right level IB lymph node swelling which is of 4x3 cm in size, firm in consistency. She has a history of fever since 1 week and cough and body pains. Clinicians has sent the patient for FNAC. I did FNAC and i got blood mixed aspirate with little amount of pus in it.
Smears are made and stained. We am suspecting it as tuberculosis (TB) and TB is most commonly seen in India too. So i asked my technician to make ZN staining to look for Acid fast bacilli.
Diagnosis
Smears have been examined and there are lymphoid cells and granulomas. The background shows necrosis. These things will favour for acid fast bacilli.
On examination of ZN stained slide. I have seen these things,
I have taken pics of the slides and we have to remember we can see them at 40X also. But we will always diagnose and will look for Acid fast bacilli in 100X with oil immersion only.
I have circled acid fast bacilli which are beaded long slender pink color ones in the blue background.
Why it is important to diagnose acid fast bacilli?
Why because it affects not only lungs but extrapulmonary structures also and it causes tuberculosis. The treatment for Tuberculosis is totally different. It has to be taken for 6 months and the drugs includes H+R+Z+E mainly.
References
- Ioachim's Lymph Node Pathology, 5th Edition
Thanks for reading,
With regards,
