Fluorescent microscopy and Ziehl–Neelsen staining of bronchoalveolar lavage, bronchial washings, bronchoscopic brushing and post bronchoscopic sputum along with cytological examination in cases of suspected tuberculosis.

Objectives: Ever since the discovery of Mycobacterium tuberculosis in 1882, many diagnostic methods have been developed. However “The gold standard” for the diagnosis of tuberculosis (TB) is still the demonstration of acid fast Bacilli (AFB) by microscopic examination of smear or bacteriological confirmation by culture method. Materials and Methods: In suspected 75 patients with active pulmonary TB, the materials obtained bronchoscopically, were bronchoalveolar lavage (BAL), bronchial brushings, bronchial washings and post bronchoscopic sputum. Four smears were made from each of the specimen. Fluorescent Staining, Ziehl–Neelsen (ZN), Pap and May Grunwald‑Giemsa (MGG) stains were carried out for cytological examination. Results: Fluorescent stain yielded maximum AFB positivity in all the methods, that is 36 (48%) in post fibre‑optic bronchoscopy (FOB) sputum and 19 (25.33%) by fluorescence microscopy in both bronchial brushings and bronchial washings. Maximum yield of AFB with ZN staining 12 (16%) was equal to the post FOB sputum and bronchial brushings samples. It was followed by 6 cases (8%) in BAL and 4 (5.3%) in bronchial washings. The cytological examination was suggestive of TB in only 8 (10.66%) cases in bronchial washings and 6 (8%) cases in post FOB collection. It was equal in BAL and Bronchial brushings each that is 5 (6.67%). Conclusion: Bronchoscopy is a useful diagnostic tool and fluorescent microscopy is more sensitive than ZN and cytology. On X‑ray examination, other diseases like malignancy or fungus can also mimick TB. So apart from ZN staining or fluorescence microscopy, Pap and MGG stain will be worthwhile to identify other microorganisms.

Lipoma of heart: A rare neoplasm seen on autopsy.

The most frequent primary tumour of the heart is myxoma, followed by lipoma, rhabdomyoma, haemangioma and lymphangioma. Primary tumors of the heart constitute 0.4% of autopsy specimens. We report a case of 40 years male who died suddenly and his heart was received in Pathology Department for examination. In the left ventricular wall, a well circumscribed yellowish mass was seen which on microscopy proved to be a lipoma.