Clinical, pathological and bacteriological study of resected pulmonary tuberculous lesions after chemotherapy

Kumar, Hans (1955) Clinical, pathological and bacteriological study of resected pulmonary tuberculous lesions after chemotherapy. Indian Journal of Tuberculosis, 2 (3). pp. 81-93.

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Abstract

The histopathology and bacteriology of tuberculous lesions resected during chemotherapy is of recognized clinical importance. This paper is based on a study of seven patients treated for pulmonary tuberculosis at Baltimore City Hospitals. The diagnosis of tuberculosis was confirmed in all cases before resection. The re- sected tissue was examined for histopathology and bacteriology in the manner out- lined in the circular on diagnostic laboratory methods revised by a Laboratory Sub- committee appointed by Thirteenth Veterans Administration Army Navy Conference on the Chemotherapy of Tuberculosis. The open lesions (cavities) and closed lesions (both unsloughed necrotic lesions and filled cavities) were examined separately and particular pains were taken to avoid cross contamination between open and closed lesions. The resected tissue was first described under the guidance of a pathologist with aseptic precautions and representative portions were excised for histopathological examinations. Acid-fast staining of tissue sections was done. Direct smears were made from open and closed lesions and examined for acid-fast bacilli by Ziehl Neelsen stain. Solid lesions were macerated and homogenized in sterile grinders using T. B. Serum Broth (Dubos) of Difco Laboratories as diluent. Diges- tion with sodium hydroxide or other chemicals was not done. The prepared homo- genate was centrifuged and the concentrated material washed three times to remove streptomycin, PAS, Isoniazid or other inhibiting agents that may be present. The final volume was adjusted with the diluent to 5 or 10 cc. depending on the sediment present. It was divided in two aliquotes, all of one portion inoculated by means of capillary pipettes into four tubes, each of Lowenstein solid media. The other ali- quote was sent to Maryland State Department of Health, Bureau of Laboratories, for guinea pig inoculation and culture. All culture tubes were retained for not less than 12 weeks before being discarded as negative.

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