Utility of acid-fast staining in tubercular lymphadenopathy compared to cytopathology

Lymphadenitis is a common form of extra-pulmonary tuberculosis. As in peripheral health centers, the facilities for histopathology and culture are lacking, material obtained by fine needle aspiration [FNA] in suspected cases of tubercular lymphadenitis [TBL] can be stained for Acid Fast Bacilli [AFB] by Ziehl Neelson method as every Designated Microscopy centre under Revised National Tuberculosis Control Programme has facility to perform it. This study was conducted with the aim of establishing the utility of performing AFB on aspirated material at a DMC over performing cytology at a higher centre. Fifty eight suspected cases of TBL attending urban health training centre, Dept. of Community Medicine were included in the study. FNA was performed and at least two slides were prepared, one for acid fast staining at centre itself and the other was sent for cytology, in the Dept. of Pathology. SPSS 11.0 was used to data analysis. 75.9% slides were AFB Positive; there was significant correlation of duration of disease and cytomorphology with AFB positivity. It was concluded that performing AFB staining at a peripheral centre on material aspirated from lymph nodes could alone be sufficient for diagnosis of tuberculosis in majority of cases

Immunohistochemistry quantification by a digital computer-assisted method compared to semiquantitative analysis

PURPOSE: To compare immunostaining quantification obtained by a digital computer-assisted method with the well-established semiquantitative analysis. METHODS: Cytoplasmic staining of galectin-3 was obtained by standard immunohistochemical reactions in 25 cases of well-differentiated thyroid carcinoma. The expression index that associates the conventional area fraction of labeled cells with the immunostaining intensity score based on visual qualitative observation was used as the semiquantitative analysis. A digital computer-assisted method is described based on the use of an image processing program (ImageLab®). Three parameters were obtained: (1) percentage of labeled cells; (2) digital immunostaining intensity, and (3) digital expression index. The proposed method allows numerical analysis of the immunostaining intensity. RESULTS: There was a strong correlation between the immunostaining intensity obtained by the two methods (Pearson correlation coefficient, r = 0.71, P = 0.0001). The same was observed between expression indexes (Pearson correlation coefficient, r = 0.66, P = 0.0001). CONCLUSION: Results obtained with our proposed digital computer-assisted method for immunoexpression analysis were concordant with the semiquantitative analysis. In addition, digital values can also resolve disagreement among different observers about the quality of staining intensity because the digital method does not classify the results into groups, but rather provides a numerical value for each individual case; thus, it increases the diagnostic and, more importantly, the prognostic sensitivity of the immunohistochemical analysis.

OBJETIVO: Comparar a quantificação da imunomarcação através de um método digital assistido por computador à bem estabelecida análise semiquantitativa. MÉTODO: A marcação citoplasmática de galectina-3 foi obtida por reações imunohistoquímicas em 25 casos de carcinoma bem-diferenciado da glândula tireóide. Determinou-se o índice de expressão da análise semiquantitativa que associa a convencional fração de área de células marcadas com os escores de intensidade da imunoexpressão, com base na observação visual qualitativa. O método digital assistido por computador foi desenvolvido com o uso de um programa de análise de imagem (ImageLab®). Três parâmetros foram obtidos: (1) porcentagem de células marcadas; (2) intensidade de imunoexpressão digital e (3) índice de expressão digital. O método proposto resulta na análise numérica da intensidade de imunoexpressão. RESULTADOS: Houve importante correlação entre as intensidades de imunoexpressão obtidas pelos dois métodos (coeficiente de correlação de Pearson, r=0,71, p=0,0001). O mesmo foi observado entre os índices de expressão (coeficiente de correlação de Pearson, r=0,66, p=0,0001). DISCUSSÃO: Os resultados de intensidade de imunoexpressão obtidos com o emprego do método digital assistido por computador foram concordantes com os escores da análise semiquantitativa. Entretanto, os resultados alcançados com o emprego do método digital podem resolver a discordância entre diferentes observadores com relação a esta intensidade de imunomarcação. Além disso, o método proposto não categoriza os resultados em grupos, o que torna a análise imunohistoquímica numericamente mensurável individualmente, aumentando seu poder diagnóstico e, sobretudo, prognóstico.

Diarrea por Enterocytozoon bieneusi: informe de un caso pediátrico / Diarrhea caused by Enteocytozoon bieneusi: a pediatric case report

En el presente trabajo, se revisa la literatura y se presenta un caso pediátrico de gastroenteritis por Enterocytozoon bieneusi en un paciente del sexo femenino de 14 meses de edad, sin historia clínica significativa, excepto desnutrición. La paciente fue estudiada por el Servicio de Parasitología del Hospital Pediátrico de Iztacalco, de la Ciudad de México, debido a un cuadro de diarrea crónica. En las muestras fecales de la paciente, se pudo identificar, mediante microscopia de luz, de microscopia de contraste interferencia diferencial según Nomarski, usando tinciones de Ziehl Neelsen modificado y Giemsa, La presencia de esporas de E. bieneusi. La presencia de otros parásitos como helmintos, protozoos, levaduras y bacterias enteropatégenas fueron excluidas mediante examen directo en fresco de materia fecal y coprocultivo

Criptosporidiosis intestinal: detección de casos en un laboratorio de referencia a nivel privado: 1988-1993 / Intestinal criptosporidiosis: detection of the cases in the referency laboratory a private level 1988-1993

Se revisaron los resultados de 272 estudios microbiológicos de heces realizados durante los años 1988 a 1993 sobre muestras procedentes depacientes en estudio por síndrome diarreico, a nivel de un laboratorio de referencia en un Hospital Privado, a las que se les realizó coloración de Kinyoun con la finalidad de detectar la inccidencia de infección intestinal por Cryptosporidium. Se detectaron 68 casos positivos (25 por ciento), correspondiendo la proporción más elevada a pacientes pediátricos (69,11 por ciento) y a pacientes del sexo masculino (60,29 por ciento). No se encontraron diferencias estadísticamente significativas en la distribución por edad y por sexo, con la prueba de chi cuadrado. La mayoría de los casos correspondieron a pacientes inmunocompetentes, y sólo 8,8 por ciento, presentaron algún tipo de inmunosupresión. En 8,8 por ciento de los casos se demostró asociación con otro agente de diarrea infecciosa. Se recomienda incluir la coloración de Kinyoun como procedimiento de rutina en el análisis de heces para diagnóstico etiológico de diarrea infecciosa, dada la elevada incidencia de criptosporidiosis encontrada, habida cuenta de que este método diagnóstico es bastante sencillo y económico

Intraobserver and interobserver reproducibility of the FAB classification in acute leukaemia.

Intraobserver and interobserver reproducibility of FAB classification for acute leukaemia was assessed using the modified criteria of the FAB classification. Leishman stained peripheral smear and May Grunwald Giemsa stained bone marrow smears from 72 cases of acute leukaemia were used for this purpose. Cytochemical stains used were peroxidase, PAS and Sudan black B. Intraobserver and interobserver concordance/discordance was calculated. Kappa statistic was used to correct the chance expected agreement. Intraobserver and interobserver concordance was 76% which improved to 91% when cytochemistry was included. Lymphocytic/Nonlymphocytic concordance was 87.5% and 90% respectively for intraobserver and interobserver groups.