Pulmonary Granulomatous Infections: Comparison of the Yield of Cultures and Histologic Examination in 88 Cases from 10 Institutions.
Sanjay Mukhopadhyay, Carol Farver, Laszlo T Vaszar, Owen Dempsey, Helmut Popper, Haresh Mani, Vera L Capelozzi, Junya Fukuoka, Keith Kerr, E Handan Zeren, Venkatesh Iyer, Tomonori Tanaka, Ivy Narde, Angheliki Nomikos, Derya Gumurdulu, Sudheer Arava, Dani S Zander, Henry D Tazelaar. SUNY Upstate Medical University, Syracuse, NY; Cleveland Clinic, OH; Mayo Clinic, Scottsdale, AZ; Aberdeen Univ Med School, United Kingdom; Med Univ of Graz, Austria; Penn State Hershey Med Ctr, Hershey, PA; Univ of São Paulo, Brazil; Toyama Univ Hosp, Japan; Çukurova Univ, Adana, Turkey; AIIMS, New Delhi, India
Background: Histology and cultures are the main methods for detecting organisms in pulmonary granulomas. However, the relative yield of these two methods is not well defined. The aim of this study was to compare the yield of histology with that of cultures for the detection of various organisms in pulmonary granulomas.
Design: Cases of pulmonary granulomatous inflammation from 10 institutions (4 US, 6 non-US) in 7 countries were retrospectively reviewed and classified as infections if an organism was identified by histology or cultures, or if serology was strongly suggestive. In cases where culture results were available, the yield of cultures was compared to that of histology.
Results: Organisms were identified in 125/500 pulmonary granulomas. Results of cultures were available in 88 cases, including cultures of biopsied lung tissue in 35 and of other respiratory tract specimens in 53. Mycobacteria were detected by cultures in 47 cases and histologically in 22. In contrast, only 7 fungi were detected on cultures whereas 31 were detected by histology.
|Organism||Total cases||Culture data available||Cultures pos, Histology neg||Cultures neg, Histology pos||Both pos|
|Fungus, unknown type||2||0||0||0||0|
|Mycobacteria, unknown type||23||5||0||5||0|