Bacteriologic Examination of Tissue Removed for Biopsy

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Abstract
14 cases are reported which are considered illustrative of some of the common errors made in trying to establish an etiologic diagnosis from tissue removed for biopsy when only a histologic examination is made. Tuberculosis was frequently not recognized when it was present. It was as frequently absent in cases in which the histologic sections were interpreted as indicating its presence; in these instances other specific organisms were isolated. Frequently it may be impossible to establish a diagnosis of blastomycosis or coccidioidomycosis by histologic methods alone because of the absence of organisms or because the organisms present may not possess adequate identifying characteristics. Brucellosis gives no characteristic histologic pattern and may be recognized in the tissue only by isolating the organism. Actino-mycosis is probably frequently confused with certain fungus infections but careful attention to the size of the filaments would, many times, avoid this error. However, Actinomyces can be distinguished with certainty from Nocardia only on culture. Because of the inherent limitations of histologic procedures, every specimen removed for biopsy should be studied as thoroughly as possible by acceptable bacteriologic methods.
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