title: The contribution of histopathological examination to the diagnosis of cervico-facial actinomycosis: a retrospective analysis of 68 cases.
abstract: Cervico-facial actinomycosis is an infectious, suppurative, and granulomatous disease due to Actinomyces species. Usually, the diagnosis is confirmed by microbiological cultures; however, the need for careful anaerobic handling of specimens often makes it difficult to obtain an effective microbial growth. Therefore, we conducted a retrospective study on biopsy samples from patients with a clinical suspicion of cervico-facial actinomycosis, in order to determine whether accurate histopathological examination could reliably confirm the diagnosis. A retrospective revision of formalin-fixed, paraffin-embedded archival material from 68 cases of cervico-facial lesions, with negative culture for anaerobic/microaerophilic microorganisms, was performed. Twelve serial sections for each case were cut from the paraffin blocks, individually collected on positively charged slides to obtain good section-to-slide adhesion, and stained with hematoxylin and eosin (H&E) and periodic acid-Schiff (PAS). Histopathological examination of the serial sections allowed the identification of bacterial colonies consistent with actinomycetes in 22 cases (32 %). The proposed histopathological examination allowed the retrospective diagnosis of cervical actinomycosis in one-third of clinical specimens that remained misdiagnosed following traditional H&E examination.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Lo Muzio
authors.forename: G
authors.initials: G
authors.lastname: Favia
authors.forename: M
authors.initials: M
authors.lastname: Lacaita
authors.forename: A
authors.initials: A
authors.lastname: De Lillo
authors.forename: C
authors.initials: C
authors.lastname: Scully
authors.forename: A
authors.initials: A
authors.lastname: Napoli
authors.forename: L
authors.initials: L
authors.lastname: Lo Russo
authors.forename: E
authors.initials: E
authors.lastname: Maiorano
mesh_terms: D000190:Actinomyces / Q000302:isolation & purification*; D000197:Actinomycosis, Cervicofacial / Q000175:diagnosis*; D001706:Biopsy; D006651:Histocytochemistry / Q000379:methods*; D006801:Humans; D008853:Microscopy / Q000379:methods*; D012189:Retrospective Studies