{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:42:11Z","timestamp":1784698931158,"version":"3.55.0"},"reference-count":47,"publisher":"Media Sphere Publishing House","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rus. J. Arch. Pathol."],"published-print":{"date-parts":[[2024,10,22]]},"abstract":"<jats:p>Tuberculosis remains a serious global problem of our time. The epidemiological situation regarding tuberculosis in the Russian Federation and in Moscow is quite favorable, however, many manifestations of diseases and morphological changes in tuberculosis require a serious approach to the timely diagnosis of the disease, especially intravital morphological verification of the process. The article outlines the main aspects of the pathogenesis of tuberculosis, including deep immunosuppression associated with HIV. A typical microscopic picture of tuberculosis inflammation is described with an algorithm for identifying the causative agent of tuberculosis in histological sections and cytological preparations, and species identification of mycobacteria in material from paraffin blocks. Attention is paid to the morphology of HIV-associated tuberculosis, which is characterized by the loss of signs of granulomatous inflammation in condition of deep immune suppression. The need for differential diagnosis of tuberculosis with many infectious and non-infectious granulomatous-necrotic processes is noted, which requires the morphologist to compare the cellular composition of granulomas, study perifocal tissue reactions and features of vascular damage, correctly assess the activity of inflammatory changes, etc. Attention is drawn to the features of the morphological diagnostic search in cases combined pathology of tuberculosis with other infectious diseases, incl. with Covid 19. Changes are difficult to analyze due to the combination of morphological manifestations of several diseases, each of which may have atypical microscopic manifestations, as well as the varying activity of several simultaneously occurring infectious processes.<\/jats:p>","DOI":"10.17116\/patol20248605181","type":"journal-article","created":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T06:31:43Z","timestamp":1729578703000},"page":"81","source":"Crossref","is-referenced-by-count":1,"title":["Issues of morphological diagnosis and pathogenesis of tuberculosis"],"prefix":"10.17116","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2814-4826","authenticated-orcid":false,"given":"Yu.R.","family":"Zyuzya","sequence":"first","affiliation":[{"name":"Moscow Research and Clinical Center for TB Control","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6743","reference":[{"key":"key-10.17116\/patol20248605181-1","unstructured":"Ministerstvo zdravookhraneniya Rossiiskoi Federatsii. Rossiiskoe obshchestvo ftiziatrov. Natsional\u2019naya assotsiatsiya nekommercheskikh organizatsii ftiziatrov \u00abAssotsiatsiya ftiziatrov\u00bb. Tuberkulez u vzroslykh. Klinicheskie rekomendatsii. 2024. (In Russ.). Available at: https:\/\/cr.minzdrav.gov.ru\/schema\/16_3#doc_a1"},{"key":"key-10.17116\/patol20248605181-2","unstructured":"Perel\u2019man MI, ed. Phthisiology. National guide. Moscow: Publishing house GEOTAR-Media; 2007. 505p. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-3","unstructured":"World Health Organization. Global tuberculosis report 2023.  https:\/\/www.who.int\/teams\/global-tuberculosis-programme\/tb-reports\/global-tuberculosis-report-2023"},{"key":"key-10.17116\/patol20248605181-4","unstructured":"World Health Organization. World tuberculosis day, 2024. https:\/\/www.who.int\/europe\/ru\/news-room\/events\/item\/2024\/03\/24\/default-calendar\/world-tb-day-2024"},{"key":"key-10.17116\/patol20248605181-5","unstructured":"Federal service for supervision of consumer rights protection and human welfare. State report \u00abOn the state of sanitary and epidemiological well-being of the population in the Russian Federation in 2022\u00bb. Moscow; 2023. 370p. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-6","unstructured":"The MNPC of tuberculosis control. Epidemiological indicators for tuberculosis in Moscow based on the results of 2023. (In Russ.). https:\/\/mnpcbt.ru\/epidSituation\/epid-pokazateli-po-tb-itog-2023"},{"key":"key-10.17116\/patol20248605181-7","unstructured":"Strukov AI, Kaufman OYa. Granulomatous inflammation and granulomatous diseases. Moscow: Meditsina; 1989. 179 p. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-8","unstructured":"Strukov AI, Solovyova IP. Morphology of tuberculosis in modern conditions. Moscow: Meditsina; 1986. 225p. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-9","unstructured":"Bloom BR, ed. Tuberculosis. Pathogenesis, protection, control. Trans. from English. Moscow: Meditsina; 2002. 677p"},{"key":"key-10.17116\/patol20248605181-10","unstructured":"Erokhin VV, Romanova LK, eds. Cellular biology of the lungs in normal and pathological conditions. A guide for doctors. Moscow: Meditsina; 2000. 496p. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-11","doi-asserted-by":"publisher","DOI":"10.24075\/vrgmu.2021.036"},{"key":"key-10.17116\/patol20248605181-12","unstructured":"Agapov MM, Tsinzerling VA. Controversial issues of the pathogenesis of tuberculosis. Clinical Pathophysiology. 2018;24(1):94-99. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-13","unstructured":"Tsinzerling VA. Unresolved issues of pathomorphology of tuberculosis. Medical Alliance. 2016;(1):21-27. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-14","doi-asserted-by":"publisher","DOI":"10.17116\/patol20157733-9"},{"key":"key-10.17116\/patol20248605181-15","doi-asserted-by":"publisher","DOI":"10.21292\/2075-1230-2017-95-2-7-12"},{"key":"key-10.17116\/patol20248605181-16","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-66325-4"},{"key":"key-10.17116\/patol20248605181-17","doi-asserted-by":"publisher","DOI":"10.17116\/patol201880340-45"},{"key":"key-10.17116\/patol20248605181-18","unstructured":"Zinserling V, Agapov M, Semenova N. PS-08-011. Histobacterioscopy studies in tuberculosis. Virchows Arch. 2019;475(Suppl. 1):121-122"},{"key":"key-10.17116\/patol20248605181-19","doi-asserted-by":"publisher","DOI":"10.54921\/2413-0346-2023-11-3-19-31"},{"key":"key-10.17116\/patol20248605181-20","unstructured":"Ellinidi VN, Ariel\u2019 BM, Samusenko IA, Tugolukova LV. The immunohistochemical method in the diagnosis of tuberculosis. Arkhiv Patologii. 2007;69(5):36-38. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-21","unstructured":"Fligil\u2019 DM. Possibilities and limitations of morphological methods for identifying pathogens of granulomatosis. Meditsinskii Vestnik Bashkortostana. 2010;(3):91-92. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-22","unstructured":"Dolgova EA, Al\u2019varez Figeroa MV, Lobashova GP, Khalina SN, Zyuzya YuR, Fligil\u2019 DM, Shipulin GA. Application of the PCR method in the diagnosis of respiratory tuberculosis in patients in the late stages of HIV infection. In: Pokrovskii VI, ed. Molekulyarnaya diagnostika. Collection of works. Vol. 1. Moscow: Publishing House MBA; 2014: 103-104. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-23","unstructured":"Erokhin VV. Functional morphology of the respiratory tract of the lungs. M.: Meditsina; 1987. 269p. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-24","doi-asserted-by":"publisher","DOI":"10.17116\/patol201577123-"},{"key":"key-10.17116\/patol20248605181-25","unstructured":"Bykhalov LS, Smirnov AV, Shmidt MV. Ultrastructural changes in lung tissue during specific inflammation in injection drug users who died from HIV\/tuberculosis co-infection. Vestnik Volgogradskogo Gosudarstvennogo Meditsinskogo Universiteta. 2016;(3):25-28. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-26","doi-asserted-by":"crossref","unstructured":"Erokhina MV, Nezlin LP, Avdienko VG, Voronezhskaya EE, Lepekha LN. Immunohistochemical detection of mycobacterium tuberculosis in lung tissue from tuberculosis patients using laser scanning microscopy. Izvestiya RAN. Seriya Biologicheskaya. 2016;(1):27-31. (In Russ.)","DOI":"10.1134\/S1062359016010052"},{"key":"key-10.17116\/patol20248605181-27","unstructured":"Parkhomenko YuG, Zyuzya YuR, Fligil\u2019 DM. Differential diagnosis of destructive lung lesions in HIV-associated infections. Arkhiv Patologii. 2011;73(5):9-12. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-28","unstructured":"Dail DH, Hammar SP. Dail and Hammar\u2019s pulmonary pathology. Springer Science and Business media; 2013. 1199 p"},{"key":"key-10.17116\/patol20248605181-29","unstructured":"Povzun SA. Productive inflammation. A manual for doctors. St. Petersbug: SpetsLit; 2018. 358p. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-30","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30979-8"},{"key":"key-10.17116\/patol20248605181-31","doi-asserted-by":"publisher","DOI":"10.1097\/TME.0000000000000287"},{"key":"key-10.17116\/patol20248605181-32","doi-asserted-by":"publisher","DOI":"10.4103\/ijmy.ijmy_80_22"},{"key":"key-10.17116\/patol20248605181-33","unstructured":"Aver\u2019yanov AV, ed. Rare diffuse lung diseases are difficult to diagnose. Trans. from Eng. Moscow: Prakticheskaya meditsina; 2022. 444p. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-34","doi-asserted-by":"crossref","unstructured":"Garmash YuYu, Borisov SE, Biron EV, Ivanushkina TN, Zyuzya YuR. Granulomatosis in the practice of a phthisiatrician. Tuberkulez i Sotsial\u2019no-Znachimye Zabolevaniya. 2023;11(2):25-54. (In Russ.)","DOI":"10.54921\/2413-0346-2023-11-2-25-54"},{"key":"key-10.17116\/patol20248605181-35","unstructured":"Tsinserling VA, Komarova DV, Rakhmanova AG, Yakovlev AA, Leonova ON. Actual problems of morphological diagnostics and pathomorphism of HIV infection. Arkhiv Patologii. 2010;72(2):26-30. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-36","unstructured":"Zyuzya YuR, Zimina VN, Al\u2019vares Figeroa MV, Parkhomenko YuG, Dolgova EA. The morphological characteristics of HIV-associated tuberculosis in relation to blood CD4+ lymphocyte counts. Archiv Patologii. 2014;76(5):33-37. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-37","doi-asserted-by":"publisher","DOI":"10.17116\/patol20248602176"},{"key":"key-10.17116\/patol20248605181-38","unstructured":"Tsinzerling AV, Tsinserling VA. Modern infections. Pathological anatomy and issues of pathogenesis. A guide. 2nd ed. St. Petersburg: SOTIS; 2002. 346p. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-39","unstructured":"Tsinzerling VA. The major problems of morphological diagnostics in HIV-infection. VICh-Infektsiya i Immunosupressii. 2009;1(2):31-37. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-40","doi-asserted-by":"crossref","unstructured":"Zinserling VA, Novitskaya TA, Orlov AN, Archakova LI. Unusual course of tuberculosis in immunosupressed patient. Virchows Arch. 2016; 469 (1): 300","DOI":"10.26226\/morressier.578f37fad462b8028d88fc9d"},{"key":"key-10.17116\/patol20248605181-41","doi-asserted-by":"crossref","unstructured":"Zyuzya YuR. Possibilities of morphological verification of HIV-associated infectious lesions in biopsy material. Tuberkulez i Sotsial\u2019no-Znachimye Zabolevaniya. 2021;9(3):26-36. (In Russ.)","DOI":"10.54921\/2413-0346-2021-12-3-26-36"},{"key":"key-10.17116\/patol20248605181-42","unstructured":"Zyuzya YuR. Parkhomenko YuG, Zimina VN, Fligil\u2019 DM. HIV-associated lungs infection - morphological verification and differential diagnosis. Klinicheskaya i Experimental\u2019naya Morphologiya. 2012;(1):21-25. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-43","unstructured":"Al\u2019vares Figeroa MV, Zyuzya YuR, Prokopenko AV, Koblova LA, Sarycheva RM. Diagnosis of a combination of tuberculosis and mycobacteriosis in HIV infection. Tuberkulez i Sotsial\u2019no-Znachimye Zabolevaniya. 2015;(4):50-57. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-44","unstructured":"Parkhomenko YuG, Zyuzya YuR, Mazus AI. Morfologicheskie aspekty VICh-infektsii. Moscow: Litterra; 2016. 168p. (In Russ.)"},{"key":"key-10.17116\/patol20248605181-45","doi-asserted-by":"publisher","DOI":"10.22625\/2072-6732-2020-12-2-5-11"},{"key":"key-10.17116\/patol20248605181-46","doi-asserted-by":"publisher","DOI":"10.19048\/2411-8729-2020-6-2-8-30"},{"key":"key-10.17116\/patol20248605181-47","unstructured":"Zyuzya YuR. Pathomorphological features of tuberculosis\/COVID-19 co-infection. Tuberkulez i Sotsial\u2019no-znachimye Zabolevaniya. 2020;(4):34-51. (In Russ.)"}],"container-title":["Russian Journal of Archive of Pathology"],"original-title":[],"language":"en","deposited":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T04:44:30Z","timestamp":1745297070000},"score":1,"resource":{"primary":{"URL":"https:\/\/mediasphera.ru\/issues\/arkhiv-patologii\/2024\/5\/1000419552024051081"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,22]]},"references-count":47,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,10,22]]}},"alternative-id":["10.17116\/patol20248605181"],"URL":"https:\/\/doi.org\/10.17116\/patol20248605181","relation":{},"ISSN":["0004-1955"],"issn-type":[{"value":"0004-1955","type":"print"}],"subject":[],"published":{"date-parts":[[2024,10,22]]}}}