Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Does The Following Biopsy Result Indicate?
Question: Based on below biopsy done for my relative -35 female pregnancy 36 weeks
“Micrscopic description-Sections shows linear cores of breast tissue with patchy stormal epitheloid histocytic aggregates,multinucleate giant cells some of langhans type with central neutrophilic aggregates.There is a moderate lymphoplasmacytic inflammatory infiltarate.No evidence of necrosis or malignancy.AFT TB and fungus stains are negative
Impression:Granuloma with supparative inflammation,trucut biopsy,left breast lesion.
Comments –please exclude tuberculosis etiology”
Queries:
1) Does it come under Tuberculosis or TB in breast?
2) if so is it can be categorized extra pulmonary TB?
3) Will all extra pulmonary TB patients impacted in organs like spine,breast etc will have pulmonary TB also as mandatory?
4) How breast TB spread in human body first time from a person having ACTIVE TB already? Is it internal or external or through skin or through blood.can it spread from person having extrapulmonary TB also?
5) Is breast TB contagious? What precautions needs in having person with breast TB at home?
“Micrscopic description-Sections shows linear cores of breast tissue with patchy stormal epitheloid histocytic aggregates,multinucleate giant cells some of langhans type with central neutrophilic aggregates.There is a moderate lymphoplasmacytic inflammatory infiltarate.No evidence of necrosis or malignancy.AFT TB and fungus stains are negative
Impression:Granuloma with supparative inflammation,trucut biopsy,left breast lesion.
Comments –please exclude tuberculosis etiology”
Queries:
1) Does it come under Tuberculosis or TB in breast?
2) if so is it can be categorized extra pulmonary TB?
3) Will all extra pulmonary TB patients impacted in organs like spine,breast etc will have pulmonary TB also as mandatory?
4) How breast TB spread in human body first time from a person having ACTIVE TB already? Is it internal or external or through skin or through blood.can it spread from person having extrapulmonary TB also?
5) Is breast TB contagious? What precautions needs in having person with breast TB at home?
Brief Answer:
Yes, it comes under extra pulmonary tuberculosis.
Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
Answer to your 1st question.
Yes, this comes under breast TB.
Answer to your 2nd question.
Yes, it comes under extra pulmonary tuberculosis.
Answer to your 3rd question.
No, this is not true. Not all extra pulmonary tuberculosis will have active pulmonary tuberculosis. Almost all extra pulmonary tuberculosis are reactivation tuberculosis.
Answer to your 4rth question.
If person is having active pulmonary TB then breast TB can be spread via either hematogenous (blood) or via lymphatic spread. No it can not be spread from patient having extra pulmonary tuberculosis.
Answer to your 5th question.
No, breast tuberculosis is not contagious.
Patient should take anti tubercular drugs according to the weight for at least 6-8 months. High protein diet is advisable for quick recovery.
Hope I have solved your query. I will be happy to help you further. Wishing good health to the patient. Thanks.
Yes, it comes under extra pulmonary tuberculosis.
Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
Answer to your 1st question.
Yes, this comes under breast TB.
Answer to your 2nd question.
Yes, it comes under extra pulmonary tuberculosis.
Answer to your 3rd question.
No, this is not true. Not all extra pulmonary tuberculosis will have active pulmonary tuberculosis. Almost all extra pulmonary tuberculosis are reactivation tuberculosis.
Answer to your 4rth question.
If person is having active pulmonary TB then breast TB can be spread via either hematogenous (blood) or via lymphatic spread. No it can not be spread from patient having extra pulmonary tuberculosis.
Answer to your 5th question.
No, breast tuberculosis is not contagious.
Patient should take anti tubercular drugs according to the weight for at least 6-8 months. High protein diet is advisable for quick recovery.
Hope I have solved your query. I will be happy to help you further. Wishing good health to the patient. Thanks.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks for ur response.Please find more questions below
1.Based on Biopsy test on breast, doctor said current abcess formed may be (
90% due to TB and 10% can be due to other infection).
As patient is pregnancy no further TB confirmation tests are done by doctor now and asked to start medication for TB based on Biopsy
Test alone.
let me know urn view is this right approach to start with TB medication,even though other tests are not done for further diagnosis..?
2.How do u confirm that in this case... PULMANARY TB is not present ...only EXTRA PULMANARY TB exists?
As TB is initially passed through air by person having active TB to new person..Initially infected person will catch this
TB through lungs only before it converts into EXTRA PULMANARY TB.
In such case how PULMANARY TB is ruled out in person having EXTRA PULMANARY TB? How lungs/throat are not effected in case of
EXTRA PULMANARY TB cases.
3. Can you explain in detail how EXTRA PULMANARY TB (breast) is developed? How long it (like hours, days etc)
Will take to become active...? What kind of interaction will be required (i.e. with person having active TB) to catch this for first time?
You mentioned breast TB can be spread via either hematogenous (blood) or via lymphatic spread.
4. Almost all extra pulmonary tuberculosis are reactivation tuberculosis.
Please explain what u mean by re activation....
5.If pregnant woman is infected with breast TB and using the TB medication,,,,
a) Will there be any impact to new born while mother is using the TB medication during pregnancy?
As mother is infected in her blood due to TB bacteria...same blood is passed to baby also right...What will be impact. ?
b) Will it impact other family members (like husband etc)... do they need to be diagonised?
What are the chances to have latent TB...for other family members...as they also might have infected by same person (ie.through neighbour, servant etc)along with pregnant woman in this case.cant alll they catch the same TB ?
c) will it impact child ...(6 to 7yrs old) due to pregnant mother having this?
1.Based on Biopsy test on breast, doctor said current abcess formed may be (
90% due to TB and 10% can be due to other infection).
As patient is pregnancy no further TB confirmation tests are done by doctor now and asked to start medication for TB based on Biopsy
Test alone.
let me know urn view is this right approach to start with TB medication,even though other tests are not done for further diagnosis..?
2.How do u confirm that in this case... PULMANARY TB is not present ...only EXTRA PULMANARY TB exists?
As TB is initially passed through air by person having active TB to new person..Initially infected person will catch this
TB through lungs only before it converts into EXTRA PULMANARY TB.
In such case how PULMANARY TB is ruled out in person having EXTRA PULMANARY TB? How lungs/throat are not effected in case of
EXTRA PULMANARY TB cases.
3. Can you explain in detail how EXTRA PULMANARY TB (breast) is developed? How long it (like hours, days etc)
Will take to become active...? What kind of interaction will be required (i.e. with person having active TB) to catch this for first time?
You mentioned breast TB can be spread via either hematogenous (blood) or via lymphatic spread.
4. Almost all extra pulmonary tuberculosis are reactivation tuberculosis.
Please explain what u mean by re activation....
5.If pregnant woman is infected with breast TB and using the TB medication,,,,
a) Will there be any impact to new born while mother is using the TB medication during pregnancy?
As mother is infected in her blood due to TB bacteria...same blood is passed to baby also right...What will be impact. ?
b) Will it impact other family members (like husband etc)... do they need to be diagonised?
What are the chances to have latent TB...for other family members...as they also might have infected by same person (ie.through neighbour, servant etc)along with pregnant woman in this case.cant alll they catch the same TB ?
c) will it impact child ...(6 to 7yrs old) due to pregnant mother having this?
Brief Answer:
If she is not having any respiratory symptoms then no need to worry for muc
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
First of all sorry for late reply as I was busy.
Here are your answers.
If patient is not having any respiratory symptoms like cough, chest pain, breathlessness, expectoration etc then no need to worry for pulmonary tuberculosis. But if you still want to confirm then get done chest x ray with abdominal shield (to prevent radiation exposure to the baby).
May I know the symptoms of her?
And your concept is wrong. Extra pulmonary TB(EPTB)is not new infection. So when person is having EPTB, it is not necessary to have pulmonary TB (PTB) always.
In XXXXXXX we all are infected in childhood. So in our body TB bacilli will stay dormant. When body's immunity is low or some stressor I there then these dormant bacilli will activate and cause extra pulmonary tuberculosis.
Most common site for this is lymphnodes (Cervical) and pleural cavity. Spine, brain, abdomen, breast etc are not much common sites for EPTB.
And in pregnancy, placenta prevents transmission of TB bacilli from mother to baby.
So no need to worry much about baby's health.
EPTB is not contagious to other family members like husband.
Hope I have solved your query.
Please let me her symptoms so that I can guide you better.
I will be happy to help you further. Wishing good health to your wife. Thanks.
If she is not having any respiratory symptoms then no need to worry for muc
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
First of all sorry for late reply as I was busy.
Here are your answers.
If patient is not having any respiratory symptoms like cough, chest pain, breathlessness, expectoration etc then no need to worry for pulmonary tuberculosis. But if you still want to confirm then get done chest x ray with abdominal shield (to prevent radiation exposure to the baby).
May I know the symptoms of her?
And your concept is wrong. Extra pulmonary TB(EPTB)is not new infection. So when person is having EPTB, it is not necessary to have pulmonary TB (PTB) always.
In XXXXXXX we all are infected in childhood. So in our body TB bacilli will stay dormant. When body's immunity is low or some stressor I there then these dormant bacilli will activate and cause extra pulmonary tuberculosis.
Most common site for this is lymphnodes (Cervical) and pleural cavity. Spine, brain, abdomen, breast etc are not much common sites for EPTB.
And in pregnancy, placenta prevents transmission of TB bacilli from mother to baby.
So no need to worry much about baby's health.
EPTB is not contagious to other family members like husband.
Hope I have solved your query.
Please let me her symptoms so that I can guide you better.
I will be happy to help you further. Wishing good health to your wife. Thanks.
Above answer was peer-reviewed by :
Dr. Kampana
Thanks for your response.
Currently patient dont have any symptoms of cough,fever,weigt loss or resporatory issues.Initially diagnosis started as
she had a abcess formed in left breast with little puss and pain during the pregnancy 2 months back( jan-17 1st week) and
finally biopsy done and shared the biopsy report earlier with you.currently she is going on with 37 week.
Based on current symptoms please answer the below questions ( ie.with each individual answers for below 6 queries)
1.Based on Biopsy test on breast, doctor said current abcess formed may be (
90% due to TB and 10% can be due to other infection).
As patient is pregnancy no further TB confirmation tests are done by doctor now and asked to start medication for TB based on Biopsy
Test alone.
let me know urn view is this right approach to start with TB medication,even though other tests are not done for further diagnosis..?
2.How do u confirm that in this case... PULMANARY TB is not present ...only EXTRA PULMANARY TB exists?
As TB is initially passed through air by person having active TB to new person..Initially infected person will catch this
TB through lungs only before it converts into EXTRA PULMANARY TB.
In such case how PULMANARY TB is ruled out in person having EXTRA PULMANARY TB? How lungs/throat are not effected in case of
EXTRA PULMANARY TB cases.
3. Can you explain in detail how EXTRA PULMANARY TB (breast) is developed? How long it (like hours, days etc)
Will take to become active...? What kind of interaction will be required (i.e. with person having active TB) to catch this for first time?
You mentioned breast TB can be spread via either hematogenous (blood) or via lymphatic spread.
need detailed answers for this?
4. Almost all extra pulmonary tuberculosis are reactivation tuberculosis.
Please explain what u mean by re activation....
5. (If pregnant woman is infected with breast TB and using the TB medication,,,,)
a) Will there be any impact to new born while mother is using the TB medication during pregnancy?
As mother is infected in her blood due to TB bacteria...same blood is passed to baby also right...What will be impact. ?
b) Any impact to other family members( like husband ,child etc) due to pregnany woman infected in the case?
6 .As infection spread from 3rd person( (ie.through neighbour, servant etc out side family(let say) to the current patient( wiht EPTB) and family
a) Due to 3rd person-will it impact other family members (like husband ,child etc)... ?
do they need to be diagonised? What are the chances to have latent TB...for other family members...as they also might have infected by 3rd person out side family along with pregnant woman in this case.
cant alll they catch the same TB ?
b will it impact child ...(6 to 7yrs old) due to 3rd person out side family
Currently patient dont have any symptoms of cough,fever,weigt loss or resporatory issues.Initially diagnosis started as
she had a abcess formed in left breast with little puss and pain during the pregnancy 2 months back( jan-17 1st week) and
finally biopsy done and shared the biopsy report earlier with you.currently she is going on with 37 week.
Based on current symptoms please answer the below questions ( ie.with each individual answers for below 6 queries)
1.Based on Biopsy test on breast, doctor said current abcess formed may be (
90% due to TB and 10% can be due to other infection).
As patient is pregnancy no further TB confirmation tests are done by doctor now and asked to start medication for TB based on Biopsy
Test alone.
let me know urn view is this right approach to start with TB medication,even though other tests are not done for further diagnosis..?
2.How do u confirm that in this case... PULMANARY TB is not present ...only EXTRA PULMANARY TB exists?
As TB is initially passed through air by person having active TB to new person..Initially infected person will catch this
TB through lungs only before it converts into EXTRA PULMANARY TB.
In such case how PULMANARY TB is ruled out in person having EXTRA PULMANARY TB? How lungs/throat are not effected in case of
EXTRA PULMANARY TB cases.
3. Can you explain in detail how EXTRA PULMANARY TB (breast) is developed? How long it (like hours, days etc)
Will take to become active...? What kind of interaction will be required (i.e. with person having active TB) to catch this for first time?
You mentioned breast TB can be spread via either hematogenous (blood) or via lymphatic spread.
need detailed answers for this?
4. Almost all extra pulmonary tuberculosis are reactivation tuberculosis.
Please explain what u mean by re activation....
5. (If pregnant woman is infected with breast TB and using the TB medication,,,,)
a) Will there be any impact to new born while mother is using the TB medication during pregnancy?
As mother is infected in her blood due to TB bacteria...same blood is passed to baby also right...What will be impact. ?
b) Any impact to other family members( like husband ,child etc) due to pregnany woman infected in the case?
6 .As infection spread from 3rd person( (ie.through neighbour, servant etc out side family(let say) to the current patient( wiht EPTB) and family
a) Due to 3rd person-will it impact other family members (like husband ,child etc)... ?
do they need to be diagonised? What are the chances to have latent TB...for other family members...as they also might have infected by 3rd person out side family along with pregnant woman in this case.
cant alll they catch the same TB ?
b will it impact child ...(6 to 7yrs old) due to 3rd person out side family
Brief Answer:
Breast TB is not contagious.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Again sorry for late reply.
Answer to your 1st question.
Yes, this treatment approach is correct. I will also be start anti tubercular drugs in such scenario.
Answer to your 2nd question.
Since patient is not having any chest symptoms, possibility of pulmonary tuberculosis is very less. Still if you want to confirm this then get done chest x ray with abdomen shield. If chest x ray is normal then no need to worry for PTB.
Answer to your 3rd question.
Extra pulmonary TB (EPTB) is almost always reactivation TB. TB bacilli remain dormant in the body. When any stressor is there, these dormant bacilli become active and cause active tuberculosis. So it is not new infection. It is reactivation. There is no reason why breast is involved.
Answer to your 4rth question.
Already explained in answer 3.
Answer to your 5th question.
a). First line anti tubercular drugs (rifampicin, isoniazid, ethambutol an pyrazinamide) are safe for new born baby. Dont give streptomycin injection. There is placenta which prevents tb bacilli migration from maternal blood to baby's blood. So baby is protected. Don't worry.
b). Breast TB is not contagious. So other family members are not at any risk.
Answer to your 6th question.
As I already said, breast TB is not due to new infection. So no role of 3rd person involvement.
Latent TB is different terminology. All Indians are at risk of latent TB. In old age due to low immunity, we can develop tuberculosis. So no specific risk for specific individual. All Indians are at risk in later part of life. And baby is safe. No need to worry.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Breast TB is not contagious.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Again sorry for late reply.
Answer to your 1st question.
Yes, this treatment approach is correct. I will also be start anti tubercular drugs in such scenario.
Answer to your 2nd question.
Since patient is not having any chest symptoms, possibility of pulmonary tuberculosis is very less. Still if you want to confirm this then get done chest x ray with abdomen shield. If chest x ray is normal then no need to worry for PTB.
Answer to your 3rd question.
Extra pulmonary TB (EPTB) is almost always reactivation TB. TB bacilli remain dormant in the body. When any stressor is there, these dormant bacilli become active and cause active tuberculosis. So it is not new infection. It is reactivation. There is no reason why breast is involved.
Answer to your 4rth question.
Already explained in answer 3.
Answer to your 5th question.
a). First line anti tubercular drugs (rifampicin, isoniazid, ethambutol an pyrazinamide) are safe for new born baby. Dont give streptomycin injection. There is placenta which prevents tb bacilli migration from maternal blood to baby's blood. So baby is protected. Don't worry.
b). Breast TB is not contagious. So other family members are not at any risk.
Answer to your 6th question.
As I already said, breast TB is not due to new infection. So no role of 3rd person involvement.
Latent TB is different terminology. All Indians are at risk of latent TB. In old age due to low immunity, we can develop tuberculosis. So no specific risk for specific individual. All Indians are at risk in later part of life. And baby is safe. No need to worry.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Kampana
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
