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The tissue is sent for histopathology, which looks for caseating granulomas with multinucleated Langhans giant cells (a distinctive cell pattern with several nuclei found in TB-type infections) Special staining of the sample using the Ziehl-Neelsen or Fite acid-fast stain (special lab stains that highlight TB-type bacteria) to look for the bacteria themselves Mycobacterial culture or polymerase chain reaction (PCR) on the biopsy material, the gold standard for confirming the species Onward referral to a medical practitioner for chest X-ray, sputum examination, an interferon-gamma release assay (IGRA, a blood test for TB exposure) or a tuberculin (Mantoux) skin test, and contact tracing Newer rapid tests such as the Xpert MTB/RIF assay can detect M