Efficacy of an in-house polymerase chain reaction assay for rapid diagnosis of Mycobacterium tuberculosis in patients with tubercular lymphadenitis: Comparison with fine needle aspiration cytology and conventional techniques

Meera Sharma, Sunil Sethi, Ashwini Kumar Mishra, Shiv Sekhar Chatterjee, Ajay Wanchu, Raje Nijhawan

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Introduction: Tubercular lymphadenitis (TB-L) is the most common manifestation of extrapulmonary tuberculosis. Excisional biopsy with histopathological examination, Ziehl-Neelsen staining (ZNS) and culture and fine needle aspiration (FNA) cytology, although useful in the diagnosis of TB-L, cannot diagnose a substantial proportion of cases. We investigated the role of an in-house polymerase chain reaction (PCR) assay targeting the IS6110 gene from the FNA material in the diagnosis of the disease. Materials and Methods: The clinical profile of 150 patients with lymphadenopathy was noted and the fine needle aspirate was collected. After cytological processing, ZNS and culture on Lowenstein-Jensen media, mycobacterial DNA was isolated from the residual aspirate material and IS6110 gene PCR was performed. Results of cytology, ZNS, culture and IS6110 gene PCR were compared. Results: There were 49 confirmed patients of TB-L based on laboratory parameters (either culture isolation of Mycobacterium tuberculosis or any two of cytology, ZNS, PCR positive) and clinical response to therapy. Sensitivity and specificity of FNA was 89.8% and 96%, of ZNS was 40.8% and 99%, of culture was 40.8% and 100% and of IS6110 gene PCR test was 100% and 92.1%. Conclusion: IS6110 PCR can be considered a valuable adjunct to cytology, ZNS and culture techniques in the diagnosis of TB-L.

Original languageEnglish (US)
Pages (from-to)714-717
Number of pages4
JournalIndian Journal of Pathology and Microbiology
Volume53
Issue number4
DOIs
StatePublished - Oct 2010
Externally publishedYes

Fingerprint

Lymphadenitis
Fine Needle Biopsy
Mycobacterium tuberculosis
Cell Biology
Staining and Labeling
Polymerase Chain Reaction
Genes
Culture Techniques
Gene Targeting
Needles
Tuberculosis
Biopsy
Sensitivity and Specificity
DNA

Keywords

  • Fine needle aspiration cytology
  • IS6110 PCR
  • tubercular lymphadenitis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Microbiology (medical)

Cite this

Efficacy of an in-house polymerase chain reaction assay for rapid diagnosis of Mycobacterium tuberculosis in patients with tubercular lymphadenitis : Comparison with fine needle aspiration cytology and conventional techniques. / Sharma, Meera; Sethi, Sunil; Mishra, Ashwini Kumar; Chatterjee, Shiv Sekhar; Wanchu, Ajay; Nijhawan, Raje.

In: Indian Journal of Pathology and Microbiology, Vol. 53, No. 4, 10.2010, p. 714-717.

Research output: Contribution to journalArticle

@article{119d2fbb55f849fa923f5b8f99620d27,
title = "Efficacy of an in-house polymerase chain reaction assay for rapid diagnosis of Mycobacterium tuberculosis in patients with tubercular lymphadenitis: Comparison with fine needle aspiration cytology and conventional techniques",
abstract = "Introduction: Tubercular lymphadenitis (TB-L) is the most common manifestation of extrapulmonary tuberculosis. Excisional biopsy with histopathological examination, Ziehl-Neelsen staining (ZNS) and culture and fine needle aspiration (FNA) cytology, although useful in the diagnosis of TB-L, cannot diagnose a substantial proportion of cases. We investigated the role of an in-house polymerase chain reaction (PCR) assay targeting the IS6110 gene from the FNA material in the diagnosis of the disease. Materials and Methods: The clinical profile of 150 patients with lymphadenopathy was noted and the fine needle aspirate was collected. After cytological processing, ZNS and culture on Lowenstein-Jensen media, mycobacterial DNA was isolated from the residual aspirate material and IS6110 gene PCR was performed. Results of cytology, ZNS, culture and IS6110 gene PCR were compared. Results: There were 49 confirmed patients of TB-L based on laboratory parameters (either culture isolation of Mycobacterium tuberculosis or any two of cytology, ZNS, PCR positive) and clinical response to therapy. Sensitivity and specificity of FNA was 89.8{\%} and 96{\%}, of ZNS was 40.8{\%} and 99{\%}, of culture was 40.8{\%} and 100{\%} and of IS6110 gene PCR test was 100{\%} and 92.1{\%}. Conclusion: IS6110 PCR can be considered a valuable adjunct to cytology, ZNS and culture techniques in the diagnosis of TB-L.",
keywords = "Fine needle aspiration cytology, IS6110 PCR, tubercular lymphadenitis",
author = "Meera Sharma and Sunil Sethi and Mishra, {Ashwini Kumar} and Chatterjee, {Shiv Sekhar} and Ajay Wanchu and Raje Nijhawan",
year = "2010",
month = "10",
doi = "10.4103/0377-4929.72049",
language = "English (US)",
volume = "53",
pages = "714--717",
journal = "Indian Journal of Pathology and Microbiology",
issn = "0377-4929",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "4",

}

TY - JOUR

T1 - Efficacy of an in-house polymerase chain reaction assay for rapid diagnosis of Mycobacterium tuberculosis in patients with tubercular lymphadenitis

T2 - Comparison with fine needle aspiration cytology and conventional techniques

AU - Sharma, Meera

AU - Sethi, Sunil

AU - Mishra, Ashwini Kumar

AU - Chatterjee, Shiv Sekhar

AU - Wanchu, Ajay

AU - Nijhawan, Raje

PY - 2010/10

Y1 - 2010/10

N2 - Introduction: Tubercular lymphadenitis (TB-L) is the most common manifestation of extrapulmonary tuberculosis. Excisional biopsy with histopathological examination, Ziehl-Neelsen staining (ZNS) and culture and fine needle aspiration (FNA) cytology, although useful in the diagnosis of TB-L, cannot diagnose a substantial proportion of cases. We investigated the role of an in-house polymerase chain reaction (PCR) assay targeting the IS6110 gene from the FNA material in the diagnosis of the disease. Materials and Methods: The clinical profile of 150 patients with lymphadenopathy was noted and the fine needle aspirate was collected. After cytological processing, ZNS and culture on Lowenstein-Jensen media, mycobacterial DNA was isolated from the residual aspirate material and IS6110 gene PCR was performed. Results of cytology, ZNS, culture and IS6110 gene PCR were compared. Results: There were 49 confirmed patients of TB-L based on laboratory parameters (either culture isolation of Mycobacterium tuberculosis or any two of cytology, ZNS, PCR positive) and clinical response to therapy. Sensitivity and specificity of FNA was 89.8% and 96%, of ZNS was 40.8% and 99%, of culture was 40.8% and 100% and of IS6110 gene PCR test was 100% and 92.1%. Conclusion: IS6110 PCR can be considered a valuable adjunct to cytology, ZNS and culture techniques in the diagnosis of TB-L.

AB - Introduction: Tubercular lymphadenitis (TB-L) is the most common manifestation of extrapulmonary tuberculosis. Excisional biopsy with histopathological examination, Ziehl-Neelsen staining (ZNS) and culture and fine needle aspiration (FNA) cytology, although useful in the diagnosis of TB-L, cannot diagnose a substantial proportion of cases. We investigated the role of an in-house polymerase chain reaction (PCR) assay targeting the IS6110 gene from the FNA material in the diagnosis of the disease. Materials and Methods: The clinical profile of 150 patients with lymphadenopathy was noted and the fine needle aspirate was collected. After cytological processing, ZNS and culture on Lowenstein-Jensen media, mycobacterial DNA was isolated from the residual aspirate material and IS6110 gene PCR was performed. Results of cytology, ZNS, culture and IS6110 gene PCR were compared. Results: There were 49 confirmed patients of TB-L based on laboratory parameters (either culture isolation of Mycobacterium tuberculosis or any two of cytology, ZNS, PCR positive) and clinical response to therapy. Sensitivity and specificity of FNA was 89.8% and 96%, of ZNS was 40.8% and 99%, of culture was 40.8% and 100% and of IS6110 gene PCR test was 100% and 92.1%. Conclusion: IS6110 PCR can be considered a valuable adjunct to cytology, ZNS and culture techniques in the diagnosis of TB-L.

KW - Fine needle aspiration cytology

KW - IS6110 PCR

KW - tubercular lymphadenitis

UR - http://www.scopus.com/inward/record.url?scp=78149391211&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78149391211&partnerID=8YFLogxK

U2 - 10.4103/0377-4929.72049

DO - 10.4103/0377-4929.72049

M3 - Article

C2 - 21045399

AN - SCOPUS:78149391211

VL - 53

SP - 714

EP - 717

JO - Indian Journal of Pathology and Microbiology

JF - Indian Journal of Pathology and Microbiology

SN - 0377-4929

IS - 4

ER -