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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Lump On Right Axillary, FNAC Showed Features Suggestive Of Non-specific Inflammation. Does She Have Tuberculosis Or Not?

Hi recently my mom feel she got some lump on her right axillary, we visit TB doctor, and he ask to do fnac . The report read fnac right axillary lump aspirated blood mixed material studied smears shows adequate celluirity of mature lymphocytes and cluster of epitheliod cells. No E/O caseous necrosis or langhan s giant cells seen. Impression- features are suggestive of granulomatous lymophadenetis possibly of Koch s etiology. We not satisfied with the report. And did another same test and report shows. Shows adipocytes, lymphocytes and occasional neutrophils. RBCs are seen in the background. No evidence of tuberculosis/ malignancy . Features are suggestive of non specific inflammation. So I m confused whether my mom have tuberculosis or not. Please help me out.
Wed, 10 Oct 2012
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Pulmonologist,  's  Response
Hi
Thanks for your query.
Its a very common problem in day to day practice.
Two options are available at your hand -
1. excision biopsy of that lymphnode and histopathological examination and BACTEC culture
2. Repeat aspirate from that lymphnode for BACTEC culture
This culture will conclusively prove whether your mom has TB or not.
Though the culture report will take time to come. Meanwhile after having biopsy and culture your mom may start anti-tubercular therapy under supervision of a chest specialist and modification of treatment may be needed after availability of report.
Again if it is due to TB then again it is necessary to differentiate between M. TB or non-tubercular mycobacteria because the incidence of later is now on increasing side and treatment is different from conventional TB.
So BACTEC culture is of utmost important here.
Thank you.
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Lump On Right Axillary, FNAC Showed Features Suggestive Of Non-specific Inflammation. Does She Have Tuberculosis Or Not?

Hi Thanks for your query. Its a very common problem in day to day practice. Two options are available at your hand - 1. excision biopsy of that lymphnode and histopathological examination and BACTEC culture 2. Repeat aspirate from that lymphnode for BACTEC culture This culture will conclusively prove whether your mom has TB or not. Though the culture report will take time to come. Meanwhile after having biopsy and culture your mom may start anti-tubercular therapy under supervision of a chest specialist and modification of treatment may be needed after availability of report. Again if it is due to TB then again it is necessary to differentiate between M. TB or non-tubercular mycobacteria because the incidence of later is now on increasing side and treatment is different from conventional TB. So BACTEC culture is of utmost important here. Thank you.