Assessment of Clinically Suspected Tubercular Lymphadenopathy by Real-Time PCR Compared to Non-Molecular Methods on Lymph Node Aspirates

Gupta, V.; Bhake, Arvind

doi:10.1159/000480064

Cited by 15 publications

(11 citation statements)

References 13 publications

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“…PCR is a valuable tool for a rapid diagnosis of TL and improves the positivity of bacteriological analysis [15]. Real-time PCR on aspirate materials has proved to be a useful molecular investigative tool in the detecting of the complex of M. tuberculosis, offering a definitive and comparable diagnosis of TL [16]. Various targets have been employed by PCR but the sequence IS6110 is widely adopted for the diagnosis of TL [17].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Fine-Needle Aspiration Cytology in the Diagnosis of Tuberculous Cervical Lymphadenitis

et al. 2018

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Objective: This study assesses the role of fine-needle aspiration cytology (FNAC) in the diagnosis of tuberculous lymphadenitis (TL) in comparison with histology and bacteriology findings. Study Design: We undertook a descriptive retrospective study of 937 FNAC specimens from 851 patients with cervical lymph nodes. The FNAC findings were then compared to histopathology and bacteriology. Results: Of the 937 aspirates, the cytopathological diagnoses consisted of 426 (55.9%) TL, 185 (24.3%) reactive lymphoid hyperplasia, 18 (2.3%) suppurative inflammation, 78 (10.2%) malignant metastatic tumor, and 54 (7%) lymphoma. Of the 426 TL cases, 171 were diagnosed by FNAC combined with bacteriological examination. In this group, 22 cases were found to be positive on Ziehl-Neelsen stain and 16 by culture. A histopathology report was available for 62 cases. Compared to histopathology, the overall diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FNAC in the diagnosis of cervical TL were, respectively, 96.77, 100, 100, and 96.67%. When comparing bacteriology to histopathology, these values were 97.44, 100, 100, and 91.67%. Conclusion: Our study shows that FNAC is a sensitive and specific tool for the diagnosis of cervical TL.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Fine-Needle Aspiration Cytology in the Diagnosis of Tuberculous Cervical Lymphadenitis

et al. 2018

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“…[1] The “captain of all these men of death,” TB has been a scourge of the human mankind from the time immemorial, not only due to its effects as a medical problem but also by its impact as a social and economic tragedy. [2] Despite availability of drugs since 1940s, TB has continued to plague mankind and remains the second most common infectious etiology of death after human immunodeficiency virus. The burden of disability and death due to TB is immense in developing and low socioeconomic regions.…”

Section: Introductionmentioning

confidence: 99%

Microbiological evaluation of clinically suspected cases of tubercular lymphadenopathy by cytology, culture, and smear microscopy – A hospital-based study from Northern India

Kant

Baveja

Sarkar

et al. 2019

J Family Med Prim Care

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Introduction: Over the past few years, the incidence of extrapulmonary tuberculosis (EPTB), particularly of tubercular lymphadenitis (TBLN), is on the rise. TBLN, which contributes to 20–40% of EPTB cases, often poses a diagnostic and therapeutic challenge for clinicians more so in resource-constrained settings where laboratory confirmation is not available. In this study, we aimed to study if fine-needle aspiration cytology (FNAC) combined with Ziehl–Neelsen (ZN) staining and mycobacterial culture could improve the diagnostic accuracy in patients clinically suspected of TBLN. Materials and Methods: This cross-sectional study involved 120 patients (>12 years of age), clinically suspected of peripheral TBLN. Direct examination of the samples with ZN staining and culture on Lowenstein–Jensen (LJ) slants and Bactec MGIT 960 vials (MGIT 960 medium) was performed on previously collected fine-needle aspirates. Results: Out of total 120 patients included in study, 43.3% were males and 56.7% were females. Maximum numbers of cases were observed in age group 13–21 (56%). On ZN staining, 21.7% samples were found positive, whereas FNAC findings were suggestive of tuberculosis (TB) in 455 patients. Culture on LJ media showed 33.3% samples to be positive, whereas Bactec MGIT 960 system showed positivity of 35%. Out of 54 samples suggestive of TB on FNAC, only 30 (55.6%) were found positive on Bactec culture. Also out of 66 samples which were not suggestive of TB in FNAC, 12 (18.2%) were found positive in Bactec culture. Conclusion: Accurate diagnosis of TBLN requires a multifaceted approach involving microbiology, pathology, radiology, and clinical presentation of the disease. FNAC and ZN staining along with the culture can result in better diagnostic yield and will be helpful in reducing the burden of TB.

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“…AFB identification can be done by various methods such as Ziehl–Neelsen (ZN) stain,[ 1 ] fluorescent stain,[ 2 ] mycobacterial culture,[ 3 ] and nucleic acid amplification test. [ 4 ] However, ZN stain is still most widely used for AFB detection.…”

Section: Introductionmentioning

confidence: 99%

Where to look for AFB in FNA Smears from tuberculous lymph nodes

Prasoon¹

2018

J Cytol

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Demonstration of acid fast bacilli (AFB) is essential for the definitive cytodiagnosis of tuberculosis. However, it is not seen in all cases of tuberculosis, being more commonly observed in necrotic lesions. Tuberculosis shows a spectrum of lesions that form a continuum extending from good immunity end with purely granulomatous lesions to poor immunity end with purely necrotic lesions. Each stage has distinctive microscopic picture and determines the chance of finding AFB. AFB yield was the highest (92.7%) in necrotic lesions containing eosinophilic structures (ES).

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Assessment of Clinically Suspected Tubercular Lymphadenopathy by Real-Time PCR Compared to Non-Molecular Methods on Lymph Node Aspirates

Cited by 15 publications

References 13 publications

Efficacy of Fine-Needle Aspiration Cytology in the Diagnosis of Tuberculous Cervical Lymphadenitis

Efficacy of Fine-Needle Aspiration Cytology in the Diagnosis of Tuberculous Cervical Lymphadenitis

Microbiological evaluation of clinically suspected cases of tubercular lymphadenopathy by cytology, culture, and smear microscopy – A hospital-based study from Northern India

Where to look for AFB in FNA Smears from tuberculous lymph nodes

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