Case 1: Lung FNA ( Fine Needle Aspirate)Yes, this is a case of granulomatous inflammation. The FNA shows numerous histiocytes and inflammatory cells with focal granuloma formation. The bean shapes of nuclei and abundant cytoplasm are characteristic features of histiocytes. Despite the FNA diagnosis, the lesion was removed due to high clinical and radiographic suspicion. H&E sections (shown below) revealed a necrotizing granulomatous penumonitis confirming the impression on FNA. DNA probe analysis of lung tissue was positive for mycobacterium arium complex (MAC). The nontubercular mycobacteria (NTM) are increasingly recognized as causative organisms of pulmonary infection in both immunocompetent and immunocompromised individuals (1). With the advent of new diagnostic techniques such as gene probes and polymerase chain reation, rapid identification of NTM (as short as 6 hours) can be achieved (2). This is important for early diagnosis and treatment in cases of ususpected pulmonary NTM. References: 1) Kanathur N et. al. Nontubercular nycobacterial pulmonary infection in immunocompetent men. South Med J 2001; 94(7): 719-23. 2) Tortoli E et. al. Performance assessment of new multiplex probe assay for identification of mycobacteria. J Clin Microbiol 2001; 39(3): 1079-84.
H&E Slide 1
H&E Slide 2
H&E Slide 3
H&E Slide 4
|
 |
