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Cytologic features of disseminated bacillus Calmette‐Guérin (BCG) infection
Author(s) -
Cohen Marta,
Drut Ricardo
Publication year - 2001
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.2021
Subject(s) - medicine , tuberculosis , pathology , giant cell , epithelioid cell , lymph node , biopsy , mycobacterium tuberculosis , granuloma , caseous necrosis , fine needle aspiration , histiocyte , lymph node biopsy , lesion , osteomyelitis , surgery , immunohistochemistry
Abstract Disseminated bacillus Calmette‐Guérin (BCG) infection is an unusual complication of immunization against Mycobacterium tuberculosis with the bacillus Calmette‐Guérin. We report on 4 such cases in which the diagnosis was suspected at the fine‐needle aspiration biopsy (FNAB) procedure. Participants were 4 males (mean age, 21.5 mo; range, 8–36 mo) in good general condition, in whom epidemiology data favoring tuberculosis and presence of pulmonary tuberculosis were lacking. Cases 1 and 2 presented with a deep‐seated subcutaneous nodule located near the left mamilla and lower aspect of the left scapula, respectively, resulting from lymph node involvement by BCG. Cases 3 and 4 presented as an osteolytic lesion of the ninth right rib and right iliac bone, respectively. FNAB findings showed poorly to moderately cellular smears. Epithelioid histiocytes in a granuloma pattern with occasional multinucleated Langerhans‐type giant cells, lymphocytes, and polymorphonuclear leukocytes in a finely granular background with necrotic debris were found in all cases. The presence of isolated calcified spherules interspersed among the cells was found to be a useful finding for diagnosis. When dealing with disseminated BCG infections, clinical and cytological pictures must be evaluated as a whole in order to arrive at an accurate diagnosis. Diagn. Cytopathol. 2001;25:134–137. © 2001 Wiley‐Liss, Inc.