of (%) AFB Percentage Features Cases Positivity of AFB Positivity Epithelioid Cell 12 20.4 2 16.7 Granulomas without Caseous Necrosis
Epithelioid Cell 31 52.5 16 51.6 Granulomas with Caseous Necrosis Caseous Necrosis
with or without Polymorphonuclear 16 27.1 11 68.7 Cells and Occasional Epithelioid Cells 59 29 49.1
The specimens were considered tubercular when typical granuloma formation with caseous necrosis
, hyaline capsule, fibrosis and epithelioid cells were present.
Different forms of cutaneous Histopathological features Observation of tuberculosis AFB Well-formed granulomas with absence of caseous necrosis
Lupus vulgaris epidermis may be atrophic or infrequent hypertrophic, featuring acanthosis, papillomatosis and even pseudo-epitheliomatous hyperplasia.
It can be difficult if caseous necrosis
and extrathyroid tuberculosis are absent.
Caption: Figure 2: (a) Large areas with caseous necrosis
(H&E x 40).
Patients with suggestive symptoms and signs, consistent radiological findings and caseous necrosis
, those having positive AFB stain or MTB cultures were clinically deemed to be TB.
On postmortem examination, the lungs showed widely disseminated white-yellowish firm nodules with central caseous necrosis
, distributed throughout the parenchyma (Figure, panel A).
The caseous necrosis
appeared frequently in the center of several granulomas.
Histological evaluation of tissue sample from the growth revealed areas of caseous necrosis
with Langhans giant cells (Figure 6).
Microscopically the lesion revealed the stratified squamous epithelium with granulomatous inflammation containing Langhans type giant cells, epithelioid cells, and foci of caseous necrosis
, strongly suggestive of tuberculosis (Figure 2).
Core needle biopsy was performed which showed severe chronic inflammation, caseous necrosis
, and stain for AFB positive (Figure 2).
Long-standing tuberculomas undergo caseous necrosis
resulting in expulsion of necrotic debris into the bronchial airways.
(9-12) The specific histopathological features of leprous neuritis include the presence of AFB and caseous necrosis
. (9,10) In the absence of AFB in the nerve biopsy specimens features like endoneurial or perineural mononuclear infiltrate and perineural fibrosis are suggestive of leprous neuritis in an endemic country.
Diagnosis is usually confirmed by finding acid fast bacilli (AFB) and positive AFB cultures of bone (positive in up to 75% of cases), and caseous necrosis
and granuloma on histopathology (11).
Hemophagocytosis, plasmacytosis, caseous necrosis
, and granulomas can be observed in bone marrow of patients with tuberculosis.14