{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:34:18Z","timestamp":1740126858580,"version":"3.37.3"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Hintergrund Okul\u00e4re Tuberkulose ist eine seltene, jedoch wichtige Differenzialdiagnose bei Entz\u00fcndungen jeglicher Augenstrukturen inkl. der Augenoberfl\u00e4che und der okul\u00e4ren Adnexe.\n\t\t\t\t\tDie Diagnostik der Gewebe kann durch deren Unzug\u00e4nglichkeit zur Biopsie, oftmals unspezifischen Ver\u00e4nderungen und den insensitiven Erregernachweis erschwert sein. Wir interessierten uns\n\t\t\t\t\tdaf\u00fcr, wie viele tuberkuloseassoziierte F\u00e4lle im Archiv des Schwerpunkts Ophthalmopathologie seit 1945 diagnostiziert wurden.<\/jats:p><jats:p>\n          Material und Methoden Wir f\u00fchrten eine retrospektive Analyse historischer Befunde und Pr\u00e4parate des Schwerpunktes Ophthalmopathologie der Klinik f\u00fcr Augenheilkunde in Freiburg durch.\n\t\t\t\t\tVerf\u00fcgbare Schnitte befundeten wir hinsichtlich Granulomen, Nekrosen, Riesenzellen, s\u00e4urefester St\u00e4bchen sowie chronischer und akuter Entz\u00fcndung systematisch neu und verglichen den aktuellen\n\t\t\t\t\tund historischen Befund. Weiterhin beschreiben wir einen aktuellen Fall eines Patienten mit Iristuberkulose.<\/jats:p><jats:p>\n          Ergebnisse Unter 50\u200a418 seit 1945 befundeten histopathologischen F\u00e4llen fanden wir 23 Befunde von 22 Patienten mit Diagnose einer okul\u00e4ren oder periokul\u00e4ren Tuberkulose. Hiervon\n\t\t\t\t\twaren 22 Pr\u00e4parate (96%) archiviert und zur Neubefundung verf\u00fcgbar. Vier Pr\u00e4parate (17%) stammten von Kindern. Die am h\u00e4ufigsten entnommenen Gewebe waren enukleierte Bulbi (10\/23, 44%),\n\t\t\t\t\tgefolgt von Tr\u00e4nensack- (5\/23, 22%) und Bindehautpr\u00e4paraten (2\/23, 9%). Die h\u00e4ufigsten histopathologischen Befunde waren Granulome (23\/23, 100%), eine chronische Entz\u00fcndung (22\/23, 96%),\n\t\t\t\t\tRiesenzellen (21\/23, 91%) und Nekrose (14\/23, 61%). Eine akute entz\u00fcndliche Reaktion fand sich in 4\/23 Pr\u00e4paraten (17%). Der Nachweis s\u00e4urefester St\u00e4bchen war aus 5 Pr\u00e4paraten angestrebt\n\t\t\t\t\tworden und hiervon in 3 F\u00e4llen gelungen (60%). Die gr\u00f6\u00dfte Diskrepanz zwischen historischer und retrospektiver Beurteilung zeigte sich im Vorhandensein von Nekrosen (\u00dcbereinstimmung in 13\/22\n\t\t\t\t\tF\u00e4llen, 59%). Die \u00fcbrigen Befunde wurden mit hoher \u00dcbereinstimmung erhoben (78\u200a\u2013\u200a96%). In einem aktuellen Fall mit Iristumor f\u00fchrte die histopathologische Aufarbeitung zeitgleich mit einem\n\t\t\t\t\tLeistenpunktat zur Tuberkulosediagnose bei zuvor tumor\u00f6s interpretierter B-Symptomatik.<\/jats:p><jats:p>\n          Schlussfolgerung Die okul\u00e4re Tuberkulose ist eine seltene, aber wichtige histopathologische Differenzialdiagnose. Das klassische Merkmal einer nekrotisierenden Entz\u00fcndung war in den\n\t\t\t\t\tverf\u00fcgbaren Pr\u00e4paraten am seltensten und wurde zudem historisch und aktuell verschiedentlich bewertet. Weitere typische Befunde wie Riesenzellen und ein pr\u00e4dominant lymphozyt\u00e4res Infiltrat\n\t\t\t\t\tk\u00f6nnen auch in F\u00e4llen mit Erregernachweis fehlen, sodass diese bei entsprechendem Verdacht nicht als obligat angesehen werden sollten.<\/jats:p>","DOI":"10.1055\/a-1780-9031","type":"journal-article","created":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T22:30:28Z","timestamp":1658356228000},"page":"876-885","source":"Crossref","is-referenced-by-count":2,"title":["Histologisch diagnostizierte okul\u00e4re und periokul\u00e4re Tuberkulose von 1945 bis 2020"],"prefix":"10.1055","volume":"239","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0758-5120","authenticated-orcid":false,"given":"Sebastian","family":"K\u00fcchlin","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Albert-Ludwigs-Universit\u00e4t Freiburg, Medizinische Fakult\u00e4t, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mateusz","family":"Glegola","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Albert-Ludwigs-Universit\u00e4t Freiburg, Medizinische Fakult\u00e4t, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tabea","family":"Schulz","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Albert-Ludwigs-Universit\u00e4t Freiburg, Medizinische Fakult\u00e4t, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3408-341X","authenticated-orcid":false,"given":"Claudia","family":"Auw-H\u00e4drich","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Albert-Ludwigs-Universit\u00e4t Freiburg, Medizinische Fakult\u00e4t, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,7,20]]},"reference":[{"volume-title":"Global tuberculosis report 2021","year":"2021","author":"World Health Organization","key":"ref1"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1016\/j.tube.2015.05.017","article-title":"Tuberculosis: A disease without boundaries","volume":"95","author":"N Fogel","year":"2015","journal-title":"Tuberculosis (Edinb)"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"102018","DOI":"10.1016\/j.tube.2020.102018","article-title":"Insights into the molecular pathogenesis of ocular tuberculosis","volume":"126","author":"R Agrawal","year":"2021","journal-title":"Tuberculosis (Edinb)"},{"key":"ref4","first-page":"509","article-title":"Okul\u00e4re Tuberkulose-Diagnostik und Therapie","volume":"30","author":"E Jakob","year":"2009","journal-title":"Z prakt Augenheilkd"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1080\/09273948.2016.1178304","article-title":"Diagnosis of Ocular Tuberculosis","volume":"26","author":"M Ang","year":"2018","journal-title":"Ocul Immunol Inflamm"},{"volume-title":"Robbins and Cotran pathologic Basis of Disease. 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