Is it possible to diagnose TB in ancient bone using microscopy?

SummaryIn paleopathology, light microscopy, particularly the use of polarized transmission light, is highly valued for the establishment of reliable diagnoses. Recently, there has been a considerable widening of our experience in the diagnosis of pathological conditions at the micro-level using thin-ground sections prepared from archaeological bone. Thus, the question has arisen as to whether it might also be possible to diagnose tuberculous disease in archaeological bone using microscopy. As a rule, the reliability of a diagnosis established on the basis of thin-ground sections depends on the state of preservation of the selected sample (e.g., pseudopathology). However, sometimes, although the preservation is fairly good, a diagnosis cannot easily be established because the characteristic criteria (e.g., mosaic structure, in Paget's disease) are not clearly observable or seem to be ambiguous. In this case, we assumed that the pathophysiological nature of the morphological structures should be analyzed (e.g., the speed of growth of pathological newly built bone formations) which might help to differentiate between nonspecific (e.g., hematogenous osteomyelitis) and specific inflammatory bone diseases (e.g., tuberculous bone disease). To verify this assumption, samples were taken from recent bone collection materials with known disease diagnoses and from archaeological specimens which show lesions suspicious of bone tuberculosis (e.g., bone tuberculosis, tuberculous meningitis).