The value of histological examination in the diagnosis of tuberculous lymphadenitis in the era of rapid molecular diagnosis

Extrapulmonary tuberculosis often poses a diagnostic challenge. This study aimed to assess the value of histological examination in diagnosing tuberculous lymphadenitis (LNTB) when performed simultaneously with rapid molecular assay (Xpert MTB/RIF) testing. People presumed to have LNTB were prospect...

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Bibliographic Details
Published in:Scientific reports 2022-05, Vol.12 (1), p.8949-8949, Article 8949
Main Authors: Tahseen, Sabira, Ambreen, Atiqa, Ishtiaq, Sheeba, Khanzada, Faisal M., Safdar, Nauman, Sviland, Lisbet, Mustafa, Tehmina
Format: Article
Language:English
Subjects:
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Bacteriology
Biopsy
Diagnosis
Histological Techniques
Histology
Histopathology
HIV
Human immunodeficiency virus
Humanities and Social Sciences
Humans
Lymph nodes
Lymph Nodes - pathology
Lymphadenitis
multidisciplinary
Mycobacterium tuberculosis - genetics
Patients
Science
Science (multidisciplinary)
Tuberculosis
Tuberculosis, Lymph Node - diagnosis
Tuberculous lymphadenitis
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Summary:Extrapulmonary tuberculosis often poses a diagnostic challenge. This study aimed to assess the value of histological examination in diagnosing tuberculous lymphadenitis (LNTB) when performed simultaneously with rapid molecular assay (Xpert MTB/RIF) testing. People presumed to have LNTB were prospectively enrolled in a tertiary care hospital. Excision biopsy was performed and tested by histology, Xpert, and culture. Of 390 lymph nodes, 11 (2.8%) were positive by AFB microscopy, 124 (31.8%) by Xpert, 137 (35.1%) by culture, and histopathology was consistent with TB in 208 (53.3%). Altogether, LNTB was diagnosed in 228 and bacteriologically confirmed TB in 178 cases. Against culture, histopathology versus Xpert had higher sensitivity (93 vs. 62%) but lower specificity (68 vs. 83%). In patients with short clinical history, a significantly higher number of Xpert-positive specimens were culture-positive. Among patients with histology suggestive of TB, no difference was seen in response to treatment between bacteriology positive and negative, but a significant slow response was noted in bacteriology confirmed TB with nonspecific histology. In a country like Pakistan, with high TB and low HIV prevalence, diagnosis is possible for more than 95% of LNTB when Xpert and histopathology examination is used in combination, compared to less than 60% by Xpert alone.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-022-12660-0