Paper Title
Dark Specks and Dark Oval Bodies: Two Valuable Structures in Tuberculous Lymphadenopathy

Abstract
Background - In aspiration biopsy cytology of lymph node stained with May Grunewald Giemsa, diagnosis of tuberculosis is established based on finding of epitheloid cells and (or) Langhans cells. However there were cases that didn’t show these two kinds of cells, should be considered as non-specific lymphadenitis, couldn’t be treated with common antibiotics, but successful with anti-tuberculous drugs. The aspirates might show either of two structures: (1) dark specks in background of eosinophilic granular necrotic material (DS), (2)small dark shrunken oval bodies in clusters of macrophages (DOB). It is desired that DS and DOB could be used as indicators of tuberculosis, and both have relation with allergic process. Methods - Immunocytochemical stain with rabbit polyclonal to Mycobacterium tuberculosis antibody (ab905), Abcam, was conducted to slides being previously diagnosed as suspected tuberculosis (by DS and DOB) and had been successfully treated with anti-tuberculous drugs. Expression of anti-mycobacterium tuberculosis antibody were examined on each of the 30 cases with DS and DOB. In addition, anti-interferon-γ (IFN-γ) and anti-interleukin-4 (IL-4) were also performed in 5 cases with DS, and in 3 with DOB. Results - Expressions of anti-mycobacterium antibody were observed on 27 of 30 cases with DS, and 21 of 30 cases with DOB. There is no difference between the two structures in respect to their ability in diagnosing of tuberculous lymphadenopathy (p>0.05). All 5 cases with DS showed strong expression of IL-4, and weak expression of IFN-γ, while in one case of DOB, the expression of IFN-γ was more intense. Conclusions - DS and DOB can be benefited as indicator of tuberculous lymphadenopathy. There was no difference in ability of DS and DOB in diagnosing tuberculous lymphadenopathy. Further research related to IFNγ and IL4 is needed to know whether DS and DOB have any relation with allergic process. Keywords - Dark Specks, Dark Oval Bodies, Tuberculous, Lymphadenopathy