Screening for Tuberculosis and Its Histological Pattern in Patients with Enlarged Lymph Node

Abstract

Settings. Tuberculosis is a major health problem in the Republic of Yemen. Tuberculous lymphadenitis is one of the most common forms of extrapulmonary tuberculosis. Therefore, this retrospective descriptive study was conducted in Yemen to investigate the morphological pattern of tuberculous lymphadenitis, as well as to assess the reliability measures of (ZN) Ziehl-Neelsen and fluorescent methods in identification of Mycobacterium tuberculosis. Methodology. One hundred lymph nodes tissue biopsies that were previously diagnosed by conventional histopathology as having tuberculous lymphadenitis were reinvestigated. Five micron in thickness sections were obtained from formalin-fixed paraffin wax processed tissues. The sections were stained using Haematoxylin and eosin (H & E), ZN, and fluorescent methods. Results. All of the 100 specimens were proved as having histopathological pattern of tuberculosis lymphadenitis. The most major histological features were giant cell (88%), caseation (84%), epithelioid cells (80%), granuloma and caseation (68%), lymphocytes (31%), and histiocytes (4%). After staining the specimens with ZN and fluorescent, of the 100 specimens only 3 (3%) and 9 (9%) specimens were found positive, by ZN and fluorescent methods, respectively. Conclusion. Conventional ZN and fluorescent methods have limitations in diagnosis of tuberculous lymphadenitis due to their lower sensitivity. Histopathology remains the most suitable method for the diagnosis of tuberculous lymphadenitis. In cases of suspected tuberculous lymphadenitis, it is advisable to confirm with more sensitive and specific method, such as polymerase chain reaction PCR or immunohistochemistry before reporting the negative results.

Factors influencing time to diagnosis and treatment among pediatric oncology patients in Kenya

“…Given the high prevalence of tuberculosis in Low income settings, most of these patients are likely to be treated with antituberculosis medication and an alternative diagnosis is only sought when there is no response several months later. [25][26] However, our median patient and physician delays for Hodgkin lymphoma patients were not extremely long compared to other types of cancers.…”

Gene Expression Profiling of Tuberculous Meningitis Co-infected with HIV

“…Diagnosis was confirmed by (i) scrape smears from the basal meninges of the brain positive for acid fast bacilli (AFB); (ii) positive antibodies/immunocomplexes in CSF against MTB by ELISA; (iii) CSF culture positive for MTB; (iv) granulomatous meningitis on histological examination with or without demonstrable AFB in histological sections by Ziehl Neelsen's staining [35]. All cases were positive for HIV-1 on serological testing and confirmed to be HIV-1 clade C by clade specific PCR developed at Jawaharlal Nehru Centre for Advanced Scientific Research, Bangalore and validated [36].…”

Staining for acid-fast bacilli in surgical pathology: practice patterns and variations

“…Nevertheless, stains for tuberculosis are often particularly challenging for pathologists. In a study of 100 cases of tuberculous lymphadenitis diagnosed by conventional histopathology, only 3 (3%) were found to be positive by Ziehl-Neelsen staining, indicating a very low sensitivity [9]. Furthermore, smears of cultured Mycobacterium tuberculosis revealed that the sensitivity of acid-fast stains (Ziehl-Neelsen and rhodamine-auramine staining) drastically decreased following formalin treatment or combined formalin and xylene treatment when compared with untreated smears [10].…”