CORRELATION OF CYTOMORPHOLOGY WITH ZN AND AR POSITIVITY ON FNAC IN THE DIAGNOSIS OF EXTRA PULMONARY TUBERCULOSIS

2021 ◽  
pp. 7-8
Author(s):  
Sana Umar ◽  
Syed Shamshad Ahmad ◽  
Kafil Akhtar ◽  
Zuber Ahmad
Keyword(s):  
Pulmonary Tuberculosis ◽  
Diagnostic Yield ◽  
Extrapulmonary Tuberculosis ◽  
Invasive Procedure ◽  
Epithelioid Cell ◽  
Chi Square ◽  
Extra Pulmonary Tuberculosis ◽  
Epithelioid Cell Granuloma ◽  
Extra Pulmonary ◽  
Low Sensitivity

BACKGROUND: FNAC is a minimally invasive procedure with a signicant diagnostic role in extrapulmonary tuberculosis. ZN Stain for demonstration of mycobacterium tuberculosis is extensively used. However, it has low sensitivity. Fluorochrome stain like Auramine- Rhodamine (AR) appear to be more likely to detect tubercular bacilli than ZN stain and also reduces the examination time. To study the OBJECTIVES: correlation of cytomorphology of extrapulmonary tuberculosis(EPTB) obtained on FNAC with ZN and AR positivity. MATERIALMETHODS: A total of 250 patients were taken, that were referred to the Department of Pathology, Jawaharlal Nehru Medical College, AMU, Aligarh from October 2015 to November 2017. Samples were collected by FNA and smears prepared were stained with H&E, ZN and AR stain. Smears were observed for positivity of Acid Fast Bacilli (AFB). Culture was taken as gold standard. RESULTS: The most common site of extra pulmonary tuberculosis was cervical lymph node seen in 76.4% cases and the most common cytomorphological pattern on FNAC was epithelioid cell granuloma with necrosis seen in 86.4% cases. The sensitivity of AR stain in picking up AFB was found to be 63.4% and the specicity was 81.9%, whereas ZN stain had a low sensitivity of 45.3% but had a high specicity of 87.9%. Statistically signicant difference between the two stains was seen on applying chi square test (p<0.001). Cohen's kappa coefcient for ZN vs AR stain was 0.65 and the strength of agreement between the two stains was substantial CONCLUSION: AR stain is more sensitive than ZN stain in diagnosing extrapulmonary tuberculosis and on combining it with cytomorphology it can help increase the diagnostic yield.

scholarly journals Comparison of diagnostic yield of GeneXpert MTB/RIF assay and ZN (Ziehl-Neelsen) staining in serosal fluids from HIV and non-HIV patients with extra-pulmonary tuberculosis

2017 ◽  
Vol 5 (7) ◽  
pp. 2952
Author(s):  
Mahim Mittal ◽  
Ritesh Kumar
Keyword(s):  
Pulmonary Tuberculosis ◽  
Clinical Diagnosis ◽  
Ascitic Fluid ◽  
Diagnostic Tool ◽  
Clinical Presentation ◽  
Diagnostic Yield ◽  
Extrapulmonary Tuberculosis ◽  
Hiv Patients ◽  
Extra Pulmonary Tuberculosis ◽  
Extra Pulmonary

Background: India accounts for 23% of the global TB burden and of these 15-20% are extrapulmonary tuberculosis(EPTB). EPTB has diverse clinical presentation and often is over diagnosed because of lack of standardised diagnostic means. Yield of acid fast bacilli (AFB) from EPTB settings is very low and alternate facilities are nearly non-existent routinely. GeneXpert MTB/RIF has been recommended as a diagnostic tool for sputum samples. It has been also recommended for serosal fluids from HIV patients only. This study was done to compare the yield of GeneXpert MTB/RIF assay and ZN (Ziehl Neelsen) staining among HIV and non-HIV patients with suspected serosal TB.Methods: GeneXpert MTB/RIF assay and ZN staining was done in all serosal fluid samples in which a clinical diagnosis of serosal TB had been made by conventional methods.Results: A total of 81 extra pulmonary samples (21 from HIV and 60 from non-HIV patients) were processed in this study, which included 48 CSF, 19 pleural fluids and 14 ascitic fluid. Out of these, 34.5% (28/81) patients were both GeneXpert MTB/RIF as well as ZN stain positive whereas only 13.58%(11/81) patients were ZN stain positive. 4/21 (19.05%) samples from HIV patients were ZN stain positive and 9/21(42.85%) were GeneXpert positive. 7/60 (11.66%) samples from non-HIV patients were ZN stain positive and 19/60 (31.66%) were GeneXpert positive.Conclusions: GeneXpert MTB/RIF is more sensitive than ZN staining in EPTB. The yield in both HIV and non-HIV patients is the same.

A STUDY ON EXTRA PULMONARY TUBERCULOSIS: SITE DISTRIBUTION

2021 ◽  
pp. 25-26
Author(s):  
Chhotala Yagnik ◽  
Vishal Oza ◽  
Chetal Suva
Keyword(s):  
Lymph Node ◽  
Pulmonary Tuberculosis ◽  
Tertiary Care Hospital ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Abdominal Tuberculosis ◽  
Care Hospital ◽  
Extra Pulmonary Tuberculosis ◽  
Site Distribution ◽  
Extra Pulmonary

Background:Extra-pulmonary tuberculosis can affect the lymph nodes, pleura, bones, joints, genito-urinary tract, nervous system (meningitis, tuberculoma), abdominal tuberculosis (intestines, mesentery, solid organs), skin. Materials and Methods: It is a record based, observational prospective study which assesses the presentation and evaluation of the site of distribution of extrapulmonary tuberculosis and management of it in a tertiary care hospital. Result:In present study, 26% of cases from lymph node TB, 20% cases from CNS and pleural TB, 18% cases from GIT, 8% cases from skeletal TB, 4% cases from GUT, 2% cases from ocular and 2% cases from pericardial TB Conclusion:The frequency of extrapulmonary TB in this study was highest in lymph node followed by pleural, CNS, GIT, skeletal and others respectively

scholarly journals Serodiagnosis of tuberculous lymphadenitis using a combination of antigens

2010 ◽  
Vol 4 (02) ◽  
pp. 096-102 ◽  
Author(s):  
Demissew Beyene ◽  
Kees Lumc Franken ◽  
Lawrence Yamuah ◽  
Abraham Aseffa ◽  
Harald G Wiker ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Serological Test ◽  
Invasive Procedure ◽  
Antibody Detection ◽  
Tuberculous Lymphadenitis ◽  
Igg Antibody ◽  
Extra Pulmonary Tuberculosis ◽  
Combined Use ◽  
Specific Igg ◽  
Low Sensitivity

Background: The diagnosis of extra-pulmonary tuberculosis (EPTB) by conventional methods such as culture and microscopy has low sensitivity and requires an invasive procedure. A simple rapid serological test would be of great value. Methodology: Six antigens (ESAT-6, Ag85A, TB10.4, Rv3881c, lipoarabinomannan (LAM) and Ara6-BSA) were tested in an ELISA to detect antigen-specific IgG and IgM antibodies in sera from 54 culture- and histology-confirmed tuberculous lymphadenitis (TBLN) patients as follows: four were HIV seropositive; sera from 25 was smear positive for pulmonary tuberculosis (PTB); 15 were culture- and histology-negative lymphadenitis (non-TBLN) patients; and 22 werehealthy controls (HCs). Results: The sensitivities of the antigens for the detection of IgG in sera of TBLN patients ranged from 4% to 30%. Specificities ranged from 73% to 100% with sera from non-TBLN patients and 91% to 100% with sera from HCs. Sensitivities of the antigens for detection of IgM ranged from 0% to 15% and specificities ranged from 80% to 100% with sera from non-TBLN patients and 91% to 100% with sera from HCs. LAM was the most potent antigen for detection of IgG. When LAM and ESAT-6 were combined, sensitivity increased up to 43% and specificity with non-TBLN was 80% with HC 96%. Conclusions: The study suggests that the combined use of LAM and ESAT-6 for IgG antibody detection in sera from TBLN patients could be a supplement to microscopy of fine-needle aspirate (FNA) to diagnose TBLN among patients suspected of TBLN.

scholarly journals Role of CB-NAAT in diagnosing extra pulmonary tuberculosis in correlation with FNA in a tertiary care center

2018 ◽  
Vol 6 (12) ◽  
pp. 4039 ◽  
Author(s):  
Sunil Kumar Komanapalli ◽  
Uma Prasad ◽  
Bhagyalakshmi Atla ◽  
Vasundhara Nammi ◽  
Divya Yendluri
Keyword(s):  
Pulmonary Tuberculosis ◽  
Light Emitting Diode ◽  
Care Center ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Nucleic Acid Amplification ◽  
Extra Pulmonary Tuberculosis ◽  
Granulomatous Lymphadenitis ◽  
Extra Pulmonary

Background: The diagnosis of extra-pulmonary tuberculosis (EPTB) is challenging due to the pauci-bacillary nature of disease. Recently, WHO recommends GeneXpert/CBNAAT to be used as the initial diagnostic test in patients suspected extra-pulmonary tuberculosis (EPTB). The study was done to assess the role of Cartridge Based Nucleic Acid Amplification Test (CB-NAAT) in the diagnosis of EPTB. Aims and objectives was to study the role of FNAC, CBNAAT and Fluorescent LED in diagnosing extra-pulmonary tuberculosis (EPTB).Methods: This is a descriptive observational study carried out over a period of 12 months (April 2017 to March 2018) at department of Pathology, Andhra Medical College. All presumptive cases of extrapulmonary tuberculosis and purulent aspirates from the various sites between the age group of <10yrs to 60 years of age were included in the study. FNA was done and material sent to CBNAAT and fluorescent LED (Light-emitting Diode) microscopy in all the cases and results tabulated.Results: The total number of cases with presumptive extra pulmonary Tb were 289. Majority of the aspirates are from lymph nodal and cervical swellings 94.1% (272/289). CBNAAT has detected 6.5 % of cases (19/289) which were not detected by FNA and 9.3% of cases (27/289) LED negative cases. Resistant to rifampicin was identified in 2.1% (3/142 cases) of CBNAAT positive cases.Conclusions: FNA still remains the cheapest test to diagnose TB. In cases with Granulomatous lymphadenitis and purulent aspirates CBNAAT has an important role in diagnosing EPTB. In addition it offered rapid detection of rifampicin-resistant M. tuberculosis strains which is an added advantage.

scholarly journals ROLE OF GENE XPERT AND LIQUID CULTURE IN DIAGNOSIS OF EXTRA PULMONAR TUBERCULOSIS

2021 ◽  
pp. 34-36
Author(s):  
Shashank Sharma ◽  
Ajith Kumar M S ◽  
Sudheer Sharma ◽  
SP Agnihotri
Keyword(s):  
Pulmonary Tuberculosis ◽  
Sensitivity And Specificity ◽  
Liquid Culture ◽  
Extrapulmonary Tuberculosis ◽  
Smear Microscopy ◽  
Gastric Aspirate ◽  
Cross Sectional ◽  
Extra Pulmonary Tuberculosis ◽  
Liquid Cultures ◽  
Extra Pulmonary

INTRODUCTION: Extrapulmonary Tuberculosis (EPTB) accounts for 15- 25% of all TB cases. It is more difficult to diagnose than Pulmonary tuberculosis and often requires invasive procedures to obtain tissue and or fluid samples. Histology is time-consuming and establishing a diagnosis of TB with high specificity remains difficult. Tissue smear microscopy after special staining is often negative. Tissue culture often leads to considerable delays compromising patient care and outcomes. AIMS AND OBJECTIVES:1. To diagnose Extra Pulmonary Tuberculosis by Gene Xpert(Xpert MTB/Rif assay or CBNAAT) and Liquid Cultures. 2. To evaluate the Sensitivity and Specificity of Gene Xpert in Extra Pulmonary Tuberculosis in comparison with Liquid Culture MGIT960 system. MATERIALS AND METHODS: This retrospective cross-sectional study was carried out by reviewing all suspected extra pulmonary tuberculosis samples of 430 patients attending OPD at Institute of Respiratory Diseases, Jaipur from April 2020 to March 2021.The extrapulmonary samples (pleural fluid,CSF,pus,BAL,Ascitic fluid,Synovial fluid,Gastric aspirate,Liver aspirate) were subjected to GeneXpert and Liquid culture MGIT960 system. RESULTS: Of the 430 Extra Pulmonary Samples, The Sensitivity and Specificity of CBNAAT was 79.77% and 95.30% respectively in comparison with Liquid Culture. Out of the 430 Samples CBNAAT was Positive in 87 samples of which 71(81.60%) were Rifampicin sensitive and 16(18.39%) were Rifampicin Resistant.Out of the 430 Samples,Liquid cultures was Positive in 89 samples. CONCLUSION: Gene Xpert has a notable advantage of detecting tuberculosis within two hours which is acceptable to all clinicians to institute early treatment.CBNAAT is one of the rapid diagnostic tests available in the country and it should be routinely used under the public and private health sector effectively to detect early tuberculosis in Extra Pulmonary Samples.

A STUDY ON EXTRA PULMONARY TUBERCULOSIS: SOCIO ECONOMIC CLASS DISTRIBUTION

2021 ◽  
pp. 3-4
Author(s):  
Chhotala Yagnik ◽  
Chetal Suva ◽  
Vishal Oza
Keyword(s):  
Nervous System ◽  
Pulmonary Tuberculosis ◽  
Tertiary Care Hospital ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Abdominal Tuberculosis ◽  
Care Hospital ◽  
Extra Pulmonary Tuberculosis ◽  
Economic Class ◽  
Extra Pulmonary

Background:Extra-pulmonary tuberculosis can affect the lymph nodes, pleura, bones, joints, genitourinary tract, nervous system (meningitis, tuberculoma), abdominal tuberculosis (intestines, mesentery, solid organs), skin. Materials and Methods: It is a record based, observational prospective study which assesses the presentation and evaluation of the socio-economic distribution of extrapulmonary tuberculosis and management of it in a tertiary care hospital. Result: In present study, out of 50 cases 52% patients were from low socio-economic class, 44% patients were from middle socioeconomic class and 4% were from high socio-economic class. Conclusion:The frequency of extrapulmonary TB in this study was highest in low socio-economic class followed by middle and high socio-economic class.

Sign in / Sign up

Export Citation Format

Share Document