Abstract
Tuberculous lymphadenitis (TBLN) is the most common form of extrapulmonary tuberculosis. However, the optimal diagnosis using Fine-Needle Aspiration Cytology (FNAC) or excisional biopsy is uncertain. This research aims to improve the diagnostic of TBLN with FNAC and immunocytochemistry (ICC) compared to the response to antituberculosis therapy. The cross-sectional study involved 43 patients with the criteria for TBLN diagnosis based on the appropriate clinical history of tuberculosis and indicative cytological results. Immunocytochemical examination employed rabbit-polyclonal to Mycobacterium tuberculosis (MTB) antibody (AB905). The MTB expression was found in 35 out of 43 cases (81%) that appropriate cytological features of the tuberculosis process. Meanwhile, eight out of 43 cases (19%) did not express MTB. Diagnostic tests for lesions with a positive cytologic appearance of TBLN and ICC were compared to the response to anti-tuberculosis therapy, revealing the sensitivity, specificity, positive predictive value, and negative predictive value of 95.2%, 75%, 95.2%, and 17%, respectively. Besides, Fisher's exact tests utilized to identify the relationship between two variables; p 0.05 was considered significant. This research found immunocytochemical study was a sensitive and specific tool for improving the diagnostic of TBLN.
Highlights
Tuberculous lymphadenitis (TBLN) is the most common form of extrapulmonary tuberculosis, with approximately one million cases worldwide each year
The diagnosis of tuberculous lymphadenitis is a challenge for pathologists because of various cytological features, such as cases of non-Mycobacterium tuberculosis (MTB) infection, other systemic disease diagnoses, and neoplastic
Another difficulty is because MTB shows paucibacillary properties and an irregular distribution that tends to be clustered, resulting in very low sensitivity to Acid Fast Bacilli (AFB) smear and conventional culture.[4]
Summary
Tuberculous lymphadenitis (TBLN) is the most common form of extrapulmonary tuberculosis, with approximately one million cases worldwide each year. The diagnosis of tuberculous lymphadenitis is a challenge for pathologists because of various cytological features, such as cases of non-MTB infection, other systemic disease diagnoses, and neoplastic. Another difficulty is because MTB shows paucibacillary properties and an irregular distribution that tends to be clustered, resulting in very low sensitivity to Acid Fast Bacilli (AFB) smear and conventional culture.[4]. The diagnosis is usually confirmed by Fine Needle Aspiration, core biopsy, or open biopsy for microscopy, culture, cytology, or histology.[5] Fine Needle Aspiration is a simple examination technique. Not infrequently, patients with complaints of swollen lymph nodes with a clinical history showing the tuberculosis process are immediately given antituberculosis drug therapy and usually always respond well
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