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Smear shows epithelioid granulomas and multinucleated giant cells in a reactive lymphoid background. Is that serious?

Cytology report for my daughter's as below :
Smears show epithelioid granulomas and multinucleated giant cells in a reactive lymphoid background (lymphoid tangles, tingible body macrophages and polymorphous population of lymphocytes). Necrotic cellular debris and many scattered neutrophils are also seen, No salivary gland tissues are detected. No cytologycal evidence of malignancy seen.
Histochemical stains : GMS is negative but Ziehl-Neelsen shows presence of acid fast bacilli.

Can Dr. advise how serious is the infection ? my daughter's is 12 year old, and we had have the cytology report just yesterday. We were advise to seek consultation for another Dr, the appointment with Dr. being fixed by end of the month, but it seems lymph node getting bigger, may i know which Dr./specialist should we look for if i intend to seek for second opinon? should we go for Anti tuberculous drugs or should undergo operation ?

Many thanks.

Evelyn Phua
Asked On : Fri, 12 Apr 2013
Answers:  2 Views:  75
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,

The cytology report of your daughter is characteristic of tuberculosis infection.
A positive ZN staining for acid fast bacilli (AFB) is confirmatory of tuberculous infection.

It is a treatable infection.
the treatment is long and is called anti tubercular treatment.
The duration of the treatment is long. It may last from 9 months to one year.
The compliance of the treatment is very important. No dose should be missed.
the whole treatment consists of atleast four medicines taken during different times.
Multivitamins and liver protective drugs should also be added in the treatment regime.

Consult a pulmonologist to start the therapy.
Thanks and take care.
Dr Shailja P Wahal
Answered: Wed, 24 Apr 2013
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Internal Medicine Specialist Dr. Omer's  Response
hi evelyn

you child is a patient of lymph node/gland tuberculosis

you need to start anti tuberculosis treatment but the nodes will enlarge after treatment and then regress.TB is common in young children who are bcg non vaccinated or had weak response to bcg.....

you need to go to infectious specialist or internal medicine specialist

take care...she will be cured
Answered: Wed, 24 Apr 2013
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