BackgroundA rapid, sensitive and accurate laboratory diagnosis is of prime importance in suspected extrapulmonary tuberculosis (EPTB) cases. However, traditional techniques for the detection of acid-fast bacilli have limitations. The aim of the study was to evaluate the diagnostic value of immunocytochemical staining for detection of Mycobacterium tuberculosis complex specific antigen, MPT64, in aspirates from pleural effusions and lymph nodes, the most common presentations of EPTB.MethodA cross-sectional study was conducted by including patients at Tikur Anbessa Specialized Hospital and the United Vision Medical Services from December 2011 to June 2012. Lymph node aspirates and pleural fluid samples were collected and analyzed from a total of 51 cases (26 tuberculous (TB) pleuritis and 25 TB lymphadenitis) and 67 non-TB controls. Each specimen was subjected to Ziehl-Neelsen (ZN) staining, culture on Lowenstein– Jensen (LJ) medium, cytological examination, Polymerase Chain Reaction (PCR) using IS1081gene sequence as a primer and immunocytochemistry (ICC) with polyclonal anti-MPT64 antibody. All patients were screened for HIV.ResultICC was positive in 38 of 51 cases and in the 7 of 67 controls giving an overall sensitivity and specificity of 74.5% and 89.5%, respectively. Using IS1081-PCR as a reference method, the sensitivity and specificity, positive and negative predictive value of ICC was 88.1%, 89.5%, 82.2% and 93.2%, respectively. The case detection rate increased from 13.7% by ZN stain to 19.6% by LJ culture, to 66.7% by cytology and 74.5% by ICC.ConclusionImmunocytochemistry with anti-MPT64 antigen improved detection of TB in pleural effusion and lymph node aspirates. Further studies using monoclonal antibodies on samples from other sites of EPTB is recommended to validate this relatively simple diagnostic method for EPTB.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0585-1) contains supplementary material, which is available to authorized users.

Pilomyxoid astrocytomas (PMA) are new class of Pilocytic Astrocytoma (PA.), which typically have their origin in hypothalamus and Chiasmatic region. There are very few case reports of PMAs arising from cerebellum. Their imaging features are similar to PA but they behave more aggressively than PA. To increase awareness of PMA within the neurosurgical community, the authors reviewed a case of 11-year-old male child who presented with truncal and cerebellar ataxia and vomiting and right cerebellar tumor diagnosed as PA radiologically but PMA on histopathology examination. These findings indicate that PMA may be a unique entity that is distinct from PA, or it may be an unusual variant.Key words: -Pilocytic astrocytoma • pilomyxoid astrocytoma • diagnosis • cerebellar DOI: http://dx.doi.org/10.4314/ecajs.v21i3.22 IntroductionPilocytic astrocytomas are generally benign, typically showing 20-year survival rates of 70 to 80%, even when only a subtotal resection is achieved. 1 These highly treatable and potentially curable pediatric tumors are considered Grade I neoplasms according to the World Health Organization tumor classification system. 2, 3 Prior to its recognition, PMA was grouped with PA, because the two display similar histological features.In 1999, Tihan and colleagues provided the sentinel description of PMAs. 1 Because of their similar histological and radiological features, 2 PMAs were classified as PAs prior to acceptance of this publication. . Earlier reports pointed out unusual features of some pediatric astrocytomas, particularly those within the hypothalamic/chiasmatic region, but did not specifically use a term to distinguish them. 4,5,9 In contrast to PAs, PMAs demonstrate a more aggressive clinical course 8-9 and appear to be associated with a higher incidence of leptomeningeal spread. 9 Pilomyxoid astrocytomas are considered to be WHO Grade II neoplasms, and most often arise from the hypothalamic/chiasmatic region. However, PMAs sometimes originate from the posterior fossa. 4 whereas hypothalamic PMAs have been well described in the literature, there is a relative paucity of information about PMAs that arise from the cerebellum. Although limited clinical experience makes it difficult to generate conclusive prognostic data regarding this recently described pediatric tumor, PMA has been shown to behave more aggressively than PA . 11 Here we report a case of cerebellar PMA in a 11 year old male child and discuss literature review Case reportThis was an 11 year old male patient who was relatively in a good state of health prior to his presentation to neurosurgical referral clinics at which time he presented with global headache,projectile vomiting of ingested matter of one moth duration, these symptoms were associated with difficulty of maintaining balance, and blurring of vision.Physical examination revealed papilledema with positive Romberg's test.Abnormal rapid alternating movements, and tandemwalk were indicative of cerebellar ataxia and truncal ataxia. Brain CT scan with contrast was done, With di...

Background Ethiopia lies in the high-risk corridor of esophageal squamous cell carcinoma in East Africa, where individuals with this malignancy often do not report established risk factors, suggesting unidentified etiologies. Here, we report the prevalence of mucosal human papillomavirus (HPV) and of Helicobacter pylori ( H. pylori ) detection in endoscopy-obtained esophageal and gastroesophageal junction biopsies and in oral cell specimens taken at the time of esophageal cancer diagnosis in a case–control study in Addis Ababa, Ethiopia. Methods DNA extraction was performed from fresh frozen tissue and oral cell pellets obtained with saline solution gargling subsequently fixed with ethanol. Mucosal HPV and H. pylori DNA was detected using highly sensitive assays that combine multiplex polymerase chain reaction and bead-based Luminex technology. The proportions of specimens testing positive were expressed as percentages, with binomial 95% confidence intervals. Agreement of results between tissue biopsy and oral cell specimens was estimated using the kappa statistic. Comparison of study participants’ characteristics by test results was done using the Pearson chi-square test. Results HPV DNA was detected in 1 of 62 tumor specimens (2, 95% confidence interval (CI): 0–9%), corresponding to HPV16 type. HPV DNA was detected in the oral cavity of 7 cases (11, 95% CI: 5–22%) and 4 of 56 matched healthy controls (7, 95% CI: 2–17%), with multiple HPV types detected. Detection of H. pylori DNA was 55% (95% CI: 42–68%), and 20 of 34 H. pylori -positive specimens (59, 95% CI: 41–75%) were positive for the cagA gene. Agreement of detection rates between tissue and oral cells in cases was poor for HPV and for H. pylori . Conclusions The prevalence of mucosal-type HPV was very low, whereas H. pylori was more commonly detected, with a high proportion testing positive for the pro-inflammatory gene cagA . These novel findings remain to be replicated in larger studies and with the addition of serological determinations to better understand their biological significance in the context of esophageal and gastroesophageal junction cancers.

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