Pseudoactinomycotic radiate granules of the gynaecological tract

Review of a diagnostic pitfall

B. Pritt, S. L. Mount, K. Cooper, H. Blaszyk

Research output: Contribution to journalReview article

22 Citations (Scopus)

Abstract

The filamentous bacterium actinomyces can cause serious gynaecological tract infections, including pelvic inflammatory disease (PID) and tubo-ovarian abscess. Thus, definitive diagnosis of actinomycotic granules (AMGs) in gynaecological specimens is clinically important. Non-infectious pseudoactinomycotic radiate granules (PAMRAGs) can mimic the microscopic appearance of AMGs. PAMRAGs may be more common than actinomycotic infections in specimens from patients using intrauterine devices and may be seen in patients with PID. Although the composition and aetiology of PAMRAGs is unclear and variable, a panel of histochemical stains can aid in diagnosis. On haematoxylin and eosin (H&E) stained sections, AMGs show as distinct granules with basophilic peripheral radiating filaments and a dense central eosinophilic core, whereas H&E stained sections of PAMRAGs feature refractile granules with irregular club-like peripheral projections and no central dense core. The filaments of AMGs are Gram positive on Brown and Brenn (B&B) stain and are highlighted with Gomori methenamine silver stain (GMS). They stain negatively with a modified acid fast bacillus (AFB) stain, aiding in the distinction of actinomyces from nocardia. PAMRAGs show negative or non-specific staining with B&B, GMS, and AFB stains. Therefore, knowledge of these staining properties and the distinguishing characteristics of PAMRAGs and AMGs enables recognition of this important diagnostic pitfall.

Original languageEnglish (US)
Pages (from-to)17-20
Number of pages4
JournalJournal of Clinical Pathology
Volume59
Issue number1
DOIs
StatePublished - Jan 2006
Externally publishedYes

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Coloring Agents
Methenamine
Actinomyces
Pelvic Inflammatory Disease
Bacillus
Staining and Labeling
Nocardia
Intrauterine Devices
Acids
Hematoxylin
Eosine Yellowish-(YS)
Infection
Abscess
Bacteria

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Pseudoactinomycotic radiate granules of the gynaecological tract : Review of a diagnostic pitfall. / Pritt, B.; Mount, S. L.; Cooper, K.; Blaszyk, H.

In: Journal of Clinical Pathology, Vol. 59, No. 1, 01.2006, p. 17-20.

Research output: Contribution to journalReview article

Pritt, B. ; Mount, S. L. ; Cooper, K. ; Blaszyk, H. / Pseudoactinomycotic radiate granules of the gynaecological tract : Review of a diagnostic pitfall. In: Journal of Clinical Pathology. 2006 ; Vol. 59, No. 1. pp. 17-20.
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