title: Granuloma in sputum cytology of pulmonary tuberculosis: a case report.
abstract: BACKGROUND
  Presence of epithelioid cell granuloma and Langhans' giant cells in sputum cytology in cases of pulmonary tuberculosis is of very uncommon occurrence. Only a few reports could be found in the English-language literature.
  
  
  METHODS
  A 73-year-old man, a chronic smoker for 50 years, reported to the medical out-patient department with complaints of cough and significant weight loss for the past 1 year. Routine sputum cytology revealed epithelioid cell granuloma along with Langhans' giant cells. Ziehl-Neelsen stain showed presence of multiple acid-fast bacilli (AFB). Chest radiography showed opacity of the airways and areas of cavitations in bilateral parahilar location and diffuse nodular opacity in bilateral lung fields.
  
  
  CONCLUSIONS
  Albeit of very rare occurrence, presence of epithelioid cell granuloma and Langhans' giant cells, along with demonstration of AFB in routine sputum cytology, is capable of providing a conclusive diagnosis in appropriate clinical context, obviating the need of additional investigation.
authors.affiliation: Department of Pathology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal. bipinkumar31@yahoo.co.in
authors.forename: Bipin
authors.initials: B
authors.lastname: Kumar
mesh_terms: D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D015622:Epithelioid Cells / Q000473:pathology; D015744:Giant Cells, Langhans / Q000473:pathology; D006099:Granuloma / Q000473:pathology*; D006801:Humans; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D013902:Radiography, Thoracic; D013183:Sputum; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*
chemical_list: D000995:Antitubercular Agents