Aparna Iyer

Endobronchial tuberculosis mimicking malignancy.

Endobronchial tuberculosis has a very varied presentation. Diagnosis is often very challenging as typical radiological features are absent and sputum smear for acid-fast bacilli is often negative. However, detection is essential as it may lead to long-term sequelae such as bronchial stenosis. Bronchoscopy is a very useful investigation in such cases. Our case is a rare manifestation of endobronchial tuberculosis as it mimicked malignancy.

Rare Case of Unilateral Hypoplasia of Lung with Associated Ventricular Mass in an Adult.

Hypoplasia of the lung is a rare congenital condition which can be: a) primary i.e. no apparent cause is found; or b) secondary i.e. associated with other congenital anomalies that are implicated in its pathogenesis. These anomalies may involve the diaphragm, cardiovascular, central nervous, urogenital and musculoskeletal system. Patients usually present in neonatal, infancy or childhood period and very rarely in adulthood. Our patient was an adult having a unilateral hypoplastic lung associated with a ventricular mass and to our knowledge this rare combination has never been reported in the English literature; though there are reports of prenatal or newborns with hypoplastic lung and rhabdomyoma of ventricle who did not survive.

Diagnostic yield of AFB smear, culture, LiPA, GeneXpert: A clinician's perspective

Background: Newer tests like GeneXpert and Line probe assay (LiPA) have replaced culture drug sensitivity for screening resistance to anti-tuberculous drugs. This study compared yield of diagnostic tests and their correlation with clinical scenario. Methods: Sputum samples from 57 TB suspects at a tertiary hospital in Navi Mumbai,India were subjected to AFB smear(ZN stain), culture(MGIT) and drug sensitivity by proportion method, GeneXpert and LiPA. Results: Comparative yield-n Comparison with culture: 27 (47.36%) were diagnosed MDR. Comparison for MDR diagnosis-n Resistance pattern by genotype assays were clinically compatible. Culture drug sensitivity by proportion method showed no resistance to INH and rifampicin in 5 cases that were detected resistant by GeneXpert and LiPA. These patients did not improve on first line drugs. Conclusions: 1. Line probe assay has a high diagnostic yield (91.42%). 2. In the event of discordance clinical correlation of genotype assays was better than culture and drug sensitivity testing .Though these numbers are too small to draw any conclusion this finding needs further evaluation on a larger scale.