Diagnosis of nontuberculous mycobacterial lymphadenitis: the role of fine-needle aspiration

Olivas-Mazón, Raquel; Blázquez‐Gamero, Daniel; Alberti-Masgrau, Nuria; López-Roa, Paula; Delgado-Muñoz, María Dolores; Epalza, Cristina

doi:10.1007/s00431-020-03875-2

Cited by 5 publications

(5 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A systematic review has shown that while sensitivity for each method is relatively low (41.8% for culture, 71.6% for PCR), both have a specificity of 100%, making them reliable for confirming the diagnosis [25]. Notably, the source for these tests matters -culture sensitivity varies from 45% for fine needle aspiration (FNA) to up to 80% for purulent discharge, compared with up to 92% for PCR from FNA or lymph node biopsy [21,26]. Hence, given widespread availability of PCR, its higher sensitivity, and that cultures can take up to six weeks [27], we recommend adding NTM PCR to the diagnostic workup when available.…”

Section: Workup and Diagnostic Modalitiesmentioning

confidence: 99%

Current management of cervicofacial nontuberculous mycobacterial infections in the pediatric population

Shah,

Peraza,

Wiedermann

2023

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

View full text Add to dashboard Cite

Purpose of review The purpose of this review is to analyze and consolidate recently published literature to provide updated guidelines on the diagnosis and management of nontuberculous mycobacterial lymphadenitis (NTM LAD) in the pediatric population and to suggest areas of further research. Recent findings Diagnosis of NTM LAD relies on a detailed clinical history, physical examination, laboratory tests, and imaging techniques. Treatment strategies vary widely, with a shift towards complete surgical excision being observed due to its higher cure rate, improved aesthetic outcomes, and lower recurrence rates. However, patient-specific factors must be considered. The role of genetic factors, such as Mendelian susceptibility to mycobacterial disease (MSMD), is being increasingly recognized and could lead to targeted therapies. Summary Despite strides in the understanding and management of NTM LAD, substantial gaps remain in key areas such as the role of diagnostic imaging, optimal treatment parameters, postoperative care, and surveillance strategies. In this article, we explain our approach to NTM using the most relevant evidence-based medicine while offering directions for future work.

show abstract

Section: Workup and Diagnostic Modalitiesmentioning

confidence: 99%

Current management of cervicofacial nontuberculous mycobacterial infections in the pediatric population

Shah,

Peraza,

Wiedermann

2023

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

View full text Add to dashboard Cite

show abstract

“…Recent reports have also suggested increased annual incidence in older children with reports of increased annual incidence at ages 11–14 years and new clusters of cases in patients aged 8–15 11 , 12 . Although the clinical picture of most NTM lymphadenitis cases is similar, it is not a straightforward diagnosis given the potential overlap with other infectious and non-infectious entities such as pyogenic lymphadenitis, tuberculous lymphadenitis, and proliferative lymphadenopathy 13 , 14 . The clinical presentation is typically of unilateral lymphadenopathy 5 , 10 .…”

Section: Introductionmentioning

confidence: 99%

“…Prodromal symptoms are often absent and have been reported in less than 25% of patients 2 – 6 , 15 . The lack of specific clinical markers has led to relying on mostly invasive techniques for the diagnosis of NTM lymphadenitis in current clinical practice 5 , 13 , 15 – 25 .…”

Section: Introductionmentioning

confidence: 99%

“…Nonetheless, diagnostic approaches such as the Tuberculin Skin Test (TST), Fine Needle Aspiration, or excisional biopsy have limitations in terms of sensitivity and specificity as well as the inadvertent complications of invasive testing 5 , 6 , 18 , 21 , 22 . The role of Purified Protein Derivative (PPD) has been evaluated with variable reported sensitivity of 5–50% for NTM and only improved role if cut off values are lowered which creates confusion in patients where prior TB exposure happened 4 , 6 , 10 , 13 , 26 , 27 . Fine Needle Aspiration (FNA) culture yield is reported at approximately 46%, with the predominant role of FNA in cases where malignancy is suspected 13 , 28 .…”

Section: Introductionmentioning

confidence: 99%

“…The role of Purified Protein Derivative (PPD) has been evaluated with variable reported sensitivity of 5–50% for NTM and only improved role if cut off values are lowered which creates confusion in patients where prior TB exposure happened 4 , 6 , 10 , 13 , 26 , 27 . Fine Needle Aspiration (FNA) culture yield is reported at approximately 46%, with the predominant role of FNA in cases where malignancy is suspected 13 , 28 . A 5 year retrospective analysis indicated that as many as 41% of presumed NTM patients are treated with an unproven diagnosis 3 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Radiomics and machine learning for the diagnosis of pediatric cervical non-tuberculous mycobacterial lymphadenitis

Bulushi

Saint‐Martin

Muthukrishnan

et al. 2022

Sci Rep

View full text Add to dashboard Cite

Non-tuberculous mycobacterial (NTM) infection is an emerging infectious entity that often presents as lymphadenitis in the pediatric age group. Current practice involves invasive testing and excisional biopsy to diagnose NTM lymphadenitis. In this study, we performed a retrospective analysis of 249 lymph nodes selected from 143 CT scans of pediatric patients presenting with lymphadenopathy at the Montreal Children’s Hospital between 2005 and 2018. A Random Forest classifier was trained on the ten most discriminative features from a set of 1231 radiomic features. The model classifying nodes as pyogenic, NTM, reactive, or proliferative lymphadenopathy achieved an accuracy of 72%, a precision of 68%, and a recall of 70%. Between NTM and all other causes of lymphadenopathy, the model achieved an area under the curve (AUC) of 89%. Between NTM and pyogenic lymphadenitis, the model achieved an AUC of 90%. Between NTM and the reactive and proliferative lymphadenopathy groups, the model achieved an AUC of 93%. These results indicate that radiomics can achieve a high accuracy for classification of NTM lymphadenitis. Such a non-invasive highly accurate diagnostic approach has the potential to reduce the need for invasive procedures in the pediatric population.

show abstract

The diagnosis of nontuberculous cervicofacial lymphadenitis: A systematic review

Saba,

Ansari,

Hoerter

et al. 2024

American Journal of Otolaryngology

View full text Add to dashboard Cite

Diagnosis of nontuberculous mycobacterial lymphadenitis: the role of fine-needle aspiration

Cited by 5 publications

References 24 publications

Current management of cervicofacial nontuberculous mycobacterial infections in the pediatric population

Current management of cervicofacial nontuberculous mycobacterial infections in the pediatric population

Radiomics and machine learning for the diagnosis of pediatric cervical non-tuberculous mycobacterial lymphadenitis

The diagnosis of nontuberculous cervicofacial lymphadenitis: A systematic review

Contact Info

Product

Resources

About