地塞米松联合异烟肼胸腔内注射治疗结核性胸膜炎临床分析

观察地塞米松联合异烟肼胸腔内注射治疗结核性胸膜炎的临床效果。方法:将我院收治的94例结核性胸膜炎患者随机分为观察组与对照组,每组各47例。对照组患者采用胸腔穿刺抽液和口服抗结核药物治疗,观察组患者在对照组基础上采用地塞米松联合异烟肼胸腔内注射治疗,观察两组患者的临床治疗效果。结果:观察组临床疗效显著,总有效率达97.87%,明显优于对照组78.72%,两组数据差异有统计学意义(P0.05)。结论:地塞米松联合异烟肼胸腔内注射治疗结核性胸膜炎疗效确切,能在短时间内消除患者胸腔积水,减轻胸膜的肥厚粘连症状,促进患者早日康复。     

康复新液联合胸腺五肽局部应用对口腔溃疡的疗效及对血清TNF-α、IL-6、SOD、SIgA、IgG的影响

目的:研究康复新液联合胸腺五肽局部应用对口腔溃疡的疗效及对血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-6(Interleukin,IL-6)、超氧化物歧化酶(Superoxide dismutase,SOD)、唾液分泌型免疫球蛋白(secretory im-munoglobulin A,SIgA)、免疫球蛋白(immunoglobulin,IgG)的影响。方法:选取2014年12月至2016年12月我院收治的86例口腔溃疡患者,按照随机数表法分为康复新液组(n=43)和联合治疗组(n=43)。康复新液组患者采取康复新液治疗,联合治疗组则采取康复新液联合胸腺五肽局部应用治疗。观察并比较两组患者临床治疗效果、症状改善情况、疼痛缓解时间和溃疡愈合时间、血清TNF-α、IL-6、SOD水平变化情况、SIgA和IgG水平以及不良反应和复发情况。结果:与治疗前比较,两组患者治疗72 h后疼痛程度均明显改善,溃疡直径显著缩小,总积分明显下降,总积分下降指数显著攀升(P0.05);血清TNF-α、IL-6水平明显下降,血清SOD水平明显升高(P0.05)。与康复新液组患者相比,联合治疗组患者总有效率明显升高(P0.05),疼痛程度、溃疡直径、总积分、总积分下降指数改善情况更优(P0.05),缓解时间和溃疡愈合时间明显缩短(P0.05),血清TNF-α、IL-6水平下降和血清SOD水平升高程度更明显(P0.05)。两组患者治疗后SIgA水平较治疗前明显升高,IgG水平较治疗前显著降低,且联合治疗组以上指标的改善情况显著优于康复新液组(P0.05),复发率明显较低(P0.05)。结论:康复新液联合胸腺五肽局部应用治疗口腔溃疡临床治疗效果明显优于康复新液单药治疗,可有效缓解疼痛、减轻患者相关症状、加速愈合,其机制可能与降低血清TNF-α、IL-6水平及提高血清SOD水平有关。     

康复新液联合雷贝拉唑治疗老年消化性溃疡的疗效

目的:关于将老年消化性溃疡患者使用康复新液联合雷贝拉唑治疗所取得的治疗的效果进行分析研讨。方法:选取在我院接受治疗的200例老年消化性溃疡患者,以随机数字表法将患者随机分成两组,各组患者100例。对照组患者进行常规的雷贝拉唑治疗,试验组患者则在对照组基础上联合康复新液进行治疗。比较并观察两组患者治疗后的效果,以及观察治疗后两组患者出现不良反应及随访一年后的复发情况。结果:经过治疗后两组患者的病情均有恢复,但试验组的临床治疗的总有效率(96.00%)大于对照组的临床治疗的总有效率(68.00%);两组患者经治疗后的随访一年后试验组患者的不良反应发生率、复发率(3.00%)、(6.00%)明显低于对照组患者不良反应发生率、复发率(29.00%)、(33.00%),统计学上均有意义(P0.05)。结论:将老年消化性溃疡患者使用康复新液联合雷贝拉唑进行治疗比单独雷贝拉唑治疗效果要好,在临床上可以广泛运用。     

康复新液联合溶菌酶肠溶片治疗阿弗他溃疡的临床疗效观察及对血清炎症因子和SIgA表达的影响

摘要 目的：探讨康复新液联合溶菌酶肠溶片治疗阿弗他溃疡的临床疗效观察及对血清炎症因子和SIgA（免疫球蛋白A）表达的影响。方法：选取我院2015年1月到2019年1月共收治的100例阿弗他溃疡患者,根据治疗方法分为观察组与对照组,每组50例患者。给予对照组患者口服葡萄糖酸锌、维生素C、维生素B联合口腔溃疡散常规治疗,给予观察组患者在对照组治疗基础上应用康复新液联合溶菌酶肠溶片治疗,对比两组患者的临床疗效果,对比两组患者血清炎症因子指标,对比两组患者SIgA和IgG,并对比两组患者的疾病复发情况。结果：对照组患者治疗总有效率为84.00 %,观察组患者治疗总有效率为95.00 %,观察组明显高于对照组（P＜0.05）;对比两组患者治疗前后的炎症因子水平发现,两组患者治疗前肿瘤坏死因子-α（tumor necrosis factor α,TNF-α）、白细胞介素-1β（interleukin-1β,IL-1β）、血栓素B2（thromboxane B2,TXB2）水平对比无明显差异（P＞0.05）,两组患者治疗后TNF-α、IL-1β、TXB2水平明显降低,且观察组低于对照组（P＜0.05）;两组患者治疗前免疫球蛋白A（secretory immunoglobulinA,SIgA）和免疫球蛋白G（immunoglobulin G,IgG）指标对比无明显差异（P＞0.05）,治疗后,观察组患者的SIgA指标明显高于对照组（P＜0.05）,观察组患者的IgG指标明显低于对照组（P＜0.05）;通过对比两组患者的疾病复发情况发现,观察组患者3个月、6个月和12个月的疾病复发率明显低于对照组（P＜0.05）。结论：对阿弗他溃疡患者应用康复新液联合溶菌酶肠溶片治疗,能够提升患者的治疗效果,减轻患者炎症情况,减少患者疾病复发情况,值得临床应用推广。     

经纤支镜治疗支气管结核的疗效观察及护理体会

目的探讨经纤支镜治疗支气管结核的疗效及护理配合措施。方法选择我院2012年10月~2013年12月确诊支气管结核患者72例,随机分为两组,对照组按常规方案进行抗结核治疗;治疗组在常规抗结核治疗的基础上,通过纤支镜灌洗并向病变部位注入药物。经纤支镜镜下治疗3个月、抗结核治疗1年以及随访1年,通过肺部CT,纤支镜刷检找抗酸杆菌,纤支镜直视下观察支气管黏膜改变,症状体征等方面比较临床疗效。结果经纤支镜灌洗及滴药治疗后,治疗组总有效率为97%,明显优于对照组的80%。结论经纤支镜局部治疗能促进病灶吸收,改善气道通气,提高患者生活质量。同时,充分的术前准备、术中密切观察及配合,是确保手术顺利完成的重要环节。     

康复新液辅助纤维支气管镜灌注联合化疗对耐多药肺结核患者肺功能、炎症因子和T淋巴细胞亚群的影响

摘要 目的：探讨康复新液辅助纤维支气管镜灌注联合化疗对耐多药肺结核患者肺功能、炎症因子和T淋巴细胞亚群的影响。方法：选取2015年1月到2017年2月期间我院收治的耐多药肺结核患者68例,根据治疗方案将患者分为对照组（n=34,纤维支气管镜灌注联合化疗）和研究组（n=34,康复新液辅助纤维支气管镜灌注联合化疗）,比较两组患者临床疗效以及肺功能、炎症因子和T淋巴细胞亚群变化,记录两组治疗期间不良反应发生情况。结果：研究组治疗12个月后、治疗20个月后病灶吸收率、痰菌转阴率、空洞闭合率均高于对照组（P<0.05）。两组患者治疗6个月后第1s用力呼气容积占预计值百分比（FEV1%）、用力肺活量占预计值百分比（FVC%）、每分钟最大通气量占预计值百分比（MVV%）、γ-干扰素（IFN-γ）、CD4⁺、CD4⁺/CD8⁺均较治疗前升高,且研究组高于对照组（P<0.05）。两组患者治疗6个月后白介素-6（IL-6）、C反应蛋白（CRP）、CD8⁺均较治疗前降低,且研究组低于对照组（P<0.05）。两组患者总不良反应发生率比较无明显差异（P>0.05）。结论：康复新液辅助纤维支气管镜灌注联合化疗治疗耐多药肺结核患者,疗效理想,能够有效改善患者肺功能和免疫功能,缓解炎症反应,安全性较好,具有一定的临床应用价值。     

伊曲康唑联合外用药物治疗花斑糠疹临床研究

目的探讨伊曲康唑胶囊联合1%盐酸布替萘芬乳膏和2%酮康唑洗剂治疗花斑糠疹的疗效及不良反应。方法入选患者按单双日分为两组,两组均口服伊曲康唑0.2g,1次/d,连续7d,同时外用1%盐酸布替萘芬乳膏,1次/d,连续14d,对照组停药观察,试验组同时使用2%酮康唑洗剂洗浴,每周2次,连用3个月。分别于治疗前、治疗后1、3、6、12个月评价疗效。结果试验组114例患者3个月时痊愈率78.1%,6个月时痊愈率90.4%,对照组125例患者3个月时痊愈率72.8%,6个月时痊愈率75.2%,12个月后试验组复发率1.8%,对照组为18.4%。结论伊曲康唑胶囊短时口服联合外用布替萘芬和酮康唑洗剂洗浴疗效较好,安全性高,使用方便,可大大降低花斑糠疹的复发率。     

布拉酵母联合小剂量红霉素 治疗小儿功能性消化不良的临床观察

目的探讨布拉酵母联合小剂量红霉素治疗小儿功能性消化不良(FD)的临床疗效。方法将92例FD患者随机分为对照组(n=46)和观察组(n=46)。对照组单纯用红霉素3～5mg/(kg·d),3次/d饭前服用。观察组在对照组治疗方法基础上联合布拉酵母0.25g/次,2次/d,餐后口服,2周一疗程。随访6个月观察其复发率。结果观察组总有效率(95.65%)明显高于对照组(76.09%),差异有统计学意义(P0.01)。2组患者治疗后HAMD评分均较治疗前下降,但观察组降低幅度显著大于对照组(P0.01)。观察组患者症状消失时间显著短于对照组,差异有统计学意义(P0.01)。治疗后随访6个月,观察组患者复发率明显低于对照组(P0.05)。结论布拉酵母联合小剂量红霉素对小儿FD具有显著的临床疗效,患者的复发率较低。     

康复新液与甲泼尼龙治疗重症手足口病的临床疗效及对患儿免疫功能的影响*

目的:探讨康复新液与甲泼尼龙联合治疗重症手足口病疗效及对生化指标的影响。方法:选自2014年1月~2015年12月我院收治的重症手足口病患儿94例,随机分为观察组与对照组,每组47例。对照组采用甲泼尼龙治疗,观察组在对照组基础上结合康复新液治疗。观察并比较两组的治疗疗效、症状体征消退时间,心肌酶和免疫功能水平的变化情况,以及不良反应。结果:观察组总有效率(93.62%)高于对照组(72.34%)(P0.05);观察组体温恢复正常、口腔溃疡愈合时间、手足皮疹消退时间优于对照组(P0.05);两组肌磷酸激酶、乳酸脱氢酶水平治疗后明显降低(P0.05);观察组肌磷酸激酶、乳酸脱氢酶水平治疗后低于对照组(P0.05);两组免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白G(Immunoglobulin G,IgG)水平治疗后明显增加(P0.05),而免疫球蛋白M(Immunoglobulin M,IgM)水平治疗前后比较无统计学差异(P0.05);观察组IgA、IgG水平治疗后高于对照组(P0.05);两组均未见严重不良反应。结论:康复新液与甲泼尼龙联合治疗重症手足口病疗效显著,可降低患儿心肌酶指标,提高患儿免疫功能,且安全性良好。     

五味消毒饮联合西药治疗胃溃疡的临床分析

目的观察五味消毒饮联合西药治疗胃溃疡的临床效果。方法选择2013年12月~2014年11月我院诊治的胃溃疡患者68例为研究对象,随机分为对照组和观察组各34例。对照组给予常规西医治疗,观察组给予五味消毒饮联合西药治疗,比较两组的临床疗效、幽门螺杆菌(Hp)根除率、不良反应以及6个月复发率。结果观察组的治疗总有效率及Hp根除率均较对照组显著提高,差异具有统计学意义(均P0.05)。观察组6个月复发率为2.94%,与对照组的26.47%比较,差异有显著统计学意义(P0.05)。两组不良反应发生率比较,差异无统计学意义(P0.05)。结论五味消毒饮联合西药治疗胃溃疡的效果确切,复发率较低,而且能够有效清除Hp,临床应用价值较高。     

Lymphadénite tuberculeuse cervicale simulant une métastase ganglionnaire d’un carcinome papillaire de la thyroïde. À propos d’un cas

Cervical lymph nodes represent one of the most frequent clinical symptoms of extrapulmonary tuberculosis. Their appearance in a neoplastic suggests lymph node metastasis. We report an atypical tuberculous lymphadenetis mimicking lymph node metastasis in a 42-year-old patient followed for papillary thyroid carcinoma operated and treated by iodine 131 therapy. Evolution was marked by the appearance of left cervical adenopathies suggesting lymph node metastatic extension on echographic criteria. A lymph node excision was undertaken and the pathologic study revealed a tuberculous lymphadenitis. The patient was put under antibacillary treatment and evolution was satisfactory. We also expose, through this work, a certain number of techniques of exploration likely to ascertain the diagnosis of a tuberculous lymphadenitis and to monitor the therapeutic strategy.     

Short course chemotherapy for tuberculous lymphadenitis in children.

OBJECTIVE--To assess the efficacy of a short course chemotherapy regimen for treating tuberculosis of the lymph nodes in children. DESIGN--Open, collaborative, outpatient clinical trial. SETTING--Outpatient department of the Tuberculosis Research Centre, paediatric surgery departments of the Institute of Child Health and Hospital for Children and the Government Stanley Hospital, Madras, South India. PATIENTS--Children aged 1-12 years with extensive, multiple site, superficial tuberculous lymphadenitis confirmed by biopsy (histopathology or culture). INTERVENTIONS--Patients were treated with a fully supervised intermittent chemotherapy regimen consisting of streptomycin, rifampicin, isoniazid, and pyrazinamide three times a week for two months followed by streptomycin and isoniazid twice a week for four months on an outpatient basis. Surgery was limited to biopsy of nodes for diagnosis and assessment. MAIN OUTCOME MEASURES--Response to chemotherapy was assessed by regression of lymph nodes and healing of sinuses and abscesses during treatment and follow up. Compliance with treatment and frequency of adverse reactions were also estimated. RESULTS--197 Patients were admitted to the study and 168 into the analysis. The regimen was well tolerated and compliance was good with 101 (60%) patients receiving the prescribed chemotherapy within 15 days of the stipulated period of six months. Those whose chemotherapy extended beyond that period received the same total number of doses. Clinical response was favourable in most patients at the end of treatment. Sinuses and abscesses healed rapidly. Residual lymphadenopathy (exceeding 10 mm diameter) was present in 50 (30%) patients at the end of treatment; these nodes were biopsied. Fresh nodes, increase in size of nodes, and sinuses and abscesses occurred both during treatment and follow up. After 36 months of follow up after treatment only 5 (3%) patients required retreatment for tuberculosis. CONCLUSION--Tuberculous lymphadenitis in children can be successfully treated with a short course chemotherapy regimen of six months.     

胸腔注射糖皮质激素联合标准四联抗结疗法对结核性胸膜炎患者临床症状及肺功能的影响

摘要 目的：探讨胸腔注射糖皮质激素联合标准四联抗结疗法对结核性胸膜炎患者肺功能及临床症状的影响。方法：选取2013年1月到2020年5月期间来我院进行诊治的结核性胸膜炎患者756例，入选的患者按照随机数字表法分为对照组和实验组，各378例。对照组予以标准四联抗结疗法治疗，实验组予以胸腔注射糖皮质激素联合标准四联抗结疗法治疗。对比两组疗效、肺功能[第1s用力呼气容积占预计值百分比（FEV₁%pred）、每分钟最大通气量占预计值百分比（MVV%pred）、用力肺活量占预计值百分比（FVC%pred）]，记录两组胸水吸收时间、胸膜厚度、临床症状缓解时间、住院时间、并发症及胸膜肥厚粘连发生情况。结果：实验组的临床总有效率较对照组高（P<0.05）。治疗后，两组FEV₁%pred、MVV%pred、FVC%pred均升高，且实验组高于对照组（P<0.05）。实验组临床症状缓解时间、胸水吸收时间、住院时间较对照组短（P<0.05），胸膜厚度大于对照组（P<0.05）。实验组的胸膜肥厚粘连、并发症总发生率低于对照组（P<0.05）。结论：胸腔注射糖皮质激素联合标准四联抗结疗法治疗结核性胸膜炎，疗效可靠，可改善患者肺功能，促进症状改善。     

Superficial mycobacterial lymphadenitis in Saskatchewan.

A total of 43 bacteriologically verified cases of superficial mycobacterial lymphadenitis were reported in Saskatchewan between 1981 and 1986; 35 (81%) were due to Mycobacterium tuberculosis. Among the eight cases (19%) due to nontuberculous mycobacteria the agent most frequently isolated was M. avium-intracellulare. Five additional cases were smear-positive and culture-negative. Direct smears of node tissue or aspirate were positive for acid-fast bacilli in 7 (88%) of the 8 cases of nontuberculous mycobacterial lymphadenitis but in only 16 (46%) of the 35 cases due to M. tuberculosis. Superficial tuberculous lymphadenitis was most frequent in female North American Indian or Asian-born adults and most commonly involved the cervical nodes. Nontuberculous mycobacterial lymphadenitis was most frequent in female white children, and most commonly involved the submandibular nodes. The cases of both tuberculous and nontuberculous mycobacterial lymphadenitis were spread throughout the province. There was an urban concentration of cases of tuberculous lymphadenitis in those of Asian origin. It is important to distinguish between superficial mycobacterial lymphadenitis due to M. tuberculosis and that due to nontuberculous mycobacteria for treatment and management purposes.     

杉醇联合奈达铂新辅助治疗局部晚期宫颈癌的临床效果研究

摘要 目的：探讨紫杉醇联合奈达铂治疗局部晚期宫颈癌患者的近远期疗效。方法：选择2010年3月～2011年8月在我院进行诊治的局部晚期宫颈癌患者67例,按住院序号分为观察组33例和对照组34例。对照组单纯给予腹腔镜宫颈癌根治手术治疗,观察组联合给予新辅助化疗(静脉注射紫杉醇135 mg/m²以及奈达铂75 mg/m²)。比较两组的临床治疗效果,术后的宫旁累及阳性率、阴道切缘阳性率、淋巴结转移阳性率以及脉管浸润阳性率。对两组患者进行3年的随访,比较两组的复发率、转移率以及3年生存率。结果：观察组的近期治疗有效率为93.94 %(31/33),明显高于对照组的70.59 %(24/34)(P<0.05);与对照组相比,观察组术后宫旁累及阳性率、阴道切缘阳性率、淋巴结转移阳性率、脉管浸润阳性率均明显较低(P<0.05);经过3年的随访,观察组的复发率以及转移率明显低于对照组(P<0.05),3年生存率明显高于对照组(P<0.05)。结论：紫杉醇联合奈达铂新辅助治疗局部晚期宫颈癌的近期疗效以及远期疗效明显优于单纯给予腹腔镜宫颈癌根治手术治疗。     

蒲地蓝配合揿针治疗小儿颈部淋巴结炎对CRP表达的影响

摘要 目的：探讨蒲地蓝配合揿针治疗小儿颈部淋巴结炎对C-反应蛋白(C-reactive protein,CRP)表达的影响。方法：2017年8月到2019年6月选择在本院诊治的小儿颈部淋巴结炎84例作为研究对象,根据随机数字表法把患儿分为联合组与对照组各42例。对照组给予蒲地蓝治疗,联合组给予蒲地蓝配合揿针治疗,疗程都为14 d,记录治疗效果与CRP表达变化情况。结果：治疗后联合组的总有效率为97.6 %,显著高于对照组的85.7 %(P<0.05)。联合组的局部消肿时间、局部压痛消退时间、发热消退时间都显著少于对照组(P<0.05)。两组治疗后的血清CRP值低于治疗前,联合组低于对照组,对比差异都有统计学意义(P<0.05)。两组治疗后的CD4⁺T淋巴细胞比例都高于治疗前,联合组高于对照组,对比差异都有统计学意义(P<0.05),两组治疗前后CD8⁺T淋巴细胞比例对比差异无统计学意义(P>0.05)。结论：蒲地蓝配合揿针治疗小儿颈部淋巴结炎能抑制CRP的释放,提高小儿的免疫功能,从而促进临床症状的消失,提高总体治疗效果。     

地塞米松联合尿激酶治疗结核性胸膜炎的临床效果分析

目的:探讨地塞米松联合尿激酶对结核性胸膜炎的临床效果。方法:选择2013年8月到2016年5月在我院进行诊治的结核性胸膜炎患者190例,根据随机信封抽签原则分为观察组与对照组各95例,两组都给予标准抗结核治疗方案,对照组在抗结核治疗的同时给予尿激酶治疗,观察组再给予地塞米松治疗,两组都治疗1个月。治疗后,比较两组的总有效率、不良反应的发生情况、胸腔积液完全引流时间、抽出胸腔积液总量、凝血酶原时间和凝血酶时间。结果:所有患者都注射耐受良好,未见严重并发症;观察组的总有效率(88.4%)明显高于对照组(72.6%);观察组胸腔积液完全引流时间和抽出胸腔积液总量分别为7.56±2.44d和2867.33±456.10 m L,对照组分别为9.44±2.89d和1989.92±444.20 m L,观察组胸腔积液完全引流时间明显短于对照组,且抽出胸腔积液总量显著高于对照组(P0.05)。治疗后,两组的凝血酶原时间和凝血酶时间都明显高于治疗前(P0.05),且观察组显著高于对照组(P0.05)。结论:地塞米松联合尿激酶治疗结核性胸膜炎能延长凝血酶时间和凝血酶原时间,缩短胸腔积液引流时间,增加抽出胸腔积液总量,安全性和临床疗效均较好。     

Genome sequence of Mycobacterium massiliense M18, isolated from a lymph node biopsy specimen

Mycobacterium massiliense is a rapidly growing mycobacterial species. The pathogenicity of this subspecies is not well known. We report here the annotated genome sequence of M. massiliense strain M18, which was isolated from a lymph node biopsy specimen from a Malaysian patient suspected of having tuberculous cervical lymphadenitis.     

Concentration of Lymph Node Aspirate Improves the Sensitivity of Acid Fast Smear Microscopy for the Diagnosis of Tuberculous Lymphadenitis in Jimma,Southwest Ethiopia

Background

Tuberculous lymphadenitis (TBLN) is the most common form of extrapulmonary tuberculosis. The cytomorphological features of lymph node smears have reduced specificity for the diagnosis of tuberculosis. The diagnosis of TBLN with direct smear microscopy lacks sensitivity due to the limited number of bacilli in lymph node aspirate. Therefore, we aimed to assess whether the concentration of lymph node aspirate improves the sensitivity of acid fast smear microscopy for the diagnosis of tuberculous lymphadenitis.

Methods

A cross-sectional comparative study was conducted on 200 patients clinically suspected for tuberculous lymphadenitis in Jimma, Ethiopia. Lymph node aspirate was collected. The first two drops were used for cytomorphological study and direct acid fast staining. The remaining aspirate was treated with N-acetyl-L-cysteine (NALC) and concentrated by centrifugation at 3000 g for 15 minutes. The sediment was used for acid fast staining and culture. Differentiation of M. tuberculosis complex (MTBC) from non-tuberculous mycobacteria (NTM) was done by para-nitrobenzoic acid susceptibility test.

Result

Complete data were available for 187 study subjects. 68% (127/187) were positive for M. tuberculosis on culture. Four isolates, 2.1% (4/187), were identified as NTM. The detection rate of direct smear microscopy was 25.1% and that of the concentration method 49.7%. Cytomorphologically, 79.7% of cases were classified as TBLN. The sensitivity of direct smear microscopy was 34.6%, for concentrated smear microscopy 66.1%, and for cytomorphology 89.8%. Two AFB positive cases on concentration method were non-tuberculosis mycobacteria (NTM). The concentration method yielded a positive result from seven cases diagnosed as suppurative abscess by cytology. Both for the direct and concentration methods the highest rate of AFB positivity was observed in smears showing caseous necrosis alone. Smear positivity rate decreased with the appearance of epithelioid cell aggregates.

Conclusion

The concentration of lymph node aspirates for acid fast smear microscopy had significantly higher sensitivity than direct microscopy.     

Diagnosing Kikuchi disease on fine needle aspiration biopsy: a retrospective study of 44 cases diagnosed by cytology and 8 by histopathology.

OBJECTIVE: To study the accuracy of fine needle aspiration (FNA) diagnosis of Kikuchi lymphadenitis (KL). STUDY DESIGN: Retrospective review of all cases of FNA biopsy of lymph nodes in which KL was diagnosed or suggested. False positive cases were studied. Cases of KL diagnosed by histopathology were examined for the false negative rate of FNA diagnosis. RESULTS: Forty-four cases of KL diagnosed or suggested by FNA were found. Five of eight cases were confirmed on lymph node excision. The false positive rate was 37.5%. One case was nonspecific reactive changes. Two cases were proven to be tuberculous lymphadenitis by culture. Eight cases of KL diagnosed by lymph node excisional biopsy had prior FNA. Four were diagnosed as or suspected to be KL. The false negative rate was 50%. CONCLUSION: The overall accuracy of FNA diagnosis of KL was 56.25%. Detailed study offalse positive cases and knowledge of other conditions suggested that overreliance on certain cytologic features and the morphologic erlap between KL and tuberculous lymphadenitis could have been the reasons for the inaccuracies.