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LETTERS TO THE EDITOR  
Year : 2018  |  Volume : 28  |  Issue : 2  |  Page : 268-269
Author's Reply


1 Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
2 Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India

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Date of Web Publication28-Jun-2018
 

How to cite this article:
Bhalla AS, Das A, Naranje P, Goyal A, Guleria R, Khilnani GC. Author's Reply. Indian J Radiol Imaging 2018;28:268-9

How to cite this URL:
Bhalla AS, Das A, Naranje P, Goyal A, Guleria R, Khilnani GC. Author's Reply. Indian J Radiol Imaging [serial online] 2018 [cited 2020 Apr 7];28:268-9. Available from: http://www.ijri.org/text.asp?2018/28/2/268/235432


Sir,

We agree with the pertinent remarks of the authors and appreciate their interest in our article. Differentiating tuberculosis from sarcoidosis with absolute certainty is difficult because of overlapping clinical and radiological features.[1] In such cases, tissue sampling is usually done; nevertheless, this distinction may not be achieved in all cases despite sampling. Even with the addition of microbiological investigations, the diagnostic yield is at best around 60%.[2],[3],[4],[5]

The purpose of this review article was to highlight the imaging similarities and differentiating features between the two entities with only a brief description of clinical and laboratory correlates. We did mention in the imaging-based algorithm proposed in our article about the use of microbiological test—CBNAAT (Gene Xpert) in initial sputum evaluation which is a part of RNTCP guidelines for assessment of tuberculosis.[6] In general, the investigation is routinely performed on any specimen obtained in a suspected case of tuberculosis, for example, bronchoalveolar lavage/fine needle aspiration/biopsy specimens. However, discussion of the implications of it being positive or negative in correlation with the pathological presence or absence of non-caseating granulomas is beyond the range of an imaging-based discussion on sarcoidosis/tuberculosis. Microbiological and pathological evaluation of this spectrum of granulomatous diseases is a complex topic in itself and requires a thorough search and analysis of the literature. Hence, inclusion of the same is beyond the purview and intent of the current article.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Bhalla AS, Das A, Naranje P, Goyal A, Guleria R, Khilnani GC. Dilemma of diagnosing thoracic sarcoidosis in tuberculosis endemic regions: An imaging-based approach. Part 1. Indian J Radiol Imaging 2017;27:369-79.  Back to cited text no. 1
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2.
Thangakunam B, Isaac BTJ, Christopher DJ. Endobronchial ultrasound experience in a high tuberculosis prevalence setting. Indian J Tuberc 2017;64:196-200.  Back to cited text no. 2
    
3.
Eom JS, Mok JH, Lee MK, Lee K, Kim MJ, Jang SM, et al. Efficacy of TB-PCR using EBUS-TBNA samples in patients with intrathoracic granulomatous lymphadenopathy. BMC Pulm Med 2015;15:166.  Back to cited text no. 3
    
4.
Prasoon D. Acid-fast bacilli in fine needle aspiration smears from tuberculous lymph nodes. Where to look for them. ActaCytol 2000;44:297-300.  Back to cited text no. 4
    
5.
Bezabih M, Mariam DW, Selassie SG. Fine needle aspiration cytology of suspected tuberculous lymphadenitis. Cytopathol2002;13:284-90.  Back to cited text no. 5
    
6.
Bhalla AS, Das A, Naranje P, Goyal A, Guleria R, Khilnani GC. Dilemma of diagnosing thoracic sarcoidosis in tuberculosis endemic regions: An imaging-based approach. Part 2. Indian J Radiol Imaging 2017;27:380-8.  Back to cited text no. 6
[PUBMED]  [Full text]  

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Correspondence Address:
Ashu S Bhalla
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijri.IJRI_85_18

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