| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
|
|
|
|
|||||||||||||
|
|
|||||||||||||||
1 Department of Biotechnology, All India Institute of Medical Sciences, New Delhi 110029, India
2 Department of Surgical Disciplines, All India Institute of Medical Sciences
3 Department of Pathology, All India Institute of Medical Sciences
4 Department of Medicine, All India Institute of Medical Sciences
5 Department of Gastrointestinal Surgery, All India Institute of Medical Sciences
6 New Delhi TB Centre, New Delhi, India
Dr Tyagi email: jstyagi{at}hotmail.com;jst{at}aiims.ernet.in Aims—To evaluate the usefulness of the devR based polymerase chain reaction (PCR) in the detection of Mycobacterium tuberculosis in lymph node aspirates and tissues of lymphadenitis and to compare PCR with conventional diagnostic techniques.
Subjects and methods—Coded specimens of fine needle aspirates and biopsies from 22 patients with tuberculous lymphadenitis, 14 patients with non-tubercular lymphadenitis, and nine patients with granulomatous lymphadenitis were processed and subjected to analysis by PCR, smear microscopy, M tuberculosis culture, histology, and cytology.
Results—Tuberculous lymphadenitis was correctly diagnosed by PCR in 18 patients, by culture in five patients, by histology in 13 patients, and by cytology in seven patients. PCR gave two false positive results in 14 patients with non-tubercular lymphadenitis. The sensitivity of the conventional techniques was significantly higher with biopsies (17 of 22 specimens; 77%) than with fine needle aspirates (nine of 22 specimens; 41%). However, the sensitivity of PCR was not significantly higher with biopsies (68%) in comparison with fine needle aspirates (55%). The sensitivity of either biopsy PCR or fine needle aspirate PCR was not significantly different from that of either histology combined with culture or cytology combined with culture. The overall combined specificity of PCR was 86%. Mycobacterium tuberculosis DNA was detected in six of nine patients with granulomatous lymphadenitis.
Conclusion—PCR is the most sensitive single technique available to date for the demonstration of M tuberculosis in specimens derived from patients with a clinical suspicion of tuberculous lymphadenitis. The value of PCR lies in its use as an adjunct test in the diagnosis of tuberculous lymphadenitis, particularly in those patients where conventional methods fail. Because fine needle aspiration is not an invasive procedure, it is the procedure of choice, and PCR should be performed initially on these samples. Excisional biopsy histology and PCR should be recommended only for patients in whom fine needle aspirate PCR is negative or when there is discrepancy with the clinical impression.
Key Words: Mycobacterium tuberculosis • devR polymerase chain reaction • tuberculous lymphadenitis
This article has been cited by other articles:
|
|
 |
|
  S. Haldar, S. Chakravorty, M. Bhalla, S. De Majumdar, and J. S. Tyagi Simplified detection of Mycobacterium tuberculosis in sputum using smear microscopy and PCR with molecular beacons J. Med. Microbiol., October 1, 2007; 56(10): 1356 - 1362. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Mishra, A. Singhal, D. S. Chauhan, V. M. Katoch, K. Srivastava, S. S. Thakral, S. S. Bharadwaj, V. Sreenivas, and H. K. Prasad Direct Detection and Identification of Mycobacterium tuberculosis and Mycobacterium bovis in Bovine Samples by a Novel Nested PCR Assay: Correlation with Conventional Techniques J. Clin. Microbiol., November 1, 2005; 43(11): 5670 - 5678. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Chakravorty, M. K. Sen, and J. S. Tyagi Diagnosis of Extrapulmonary Tuberculosis by Smear, Culture, and PCR Using Universal Sample Processing Technology J. Clin. Microbiol., September 1, 2005; 43(9): 4357 - 4362. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Pahwa, S. Hedau, S. Jain, N. Jain, V. M Arora, N. Kumar, and B. C Das Assessment of possible tuberculous lymphadenopathy by PCR compared to non-molecular methods J. Med. Microbiol., September 1, 2005; 54(9): 873 - 878. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Chakravorty and J. S. Tyagi Novel Multipurpose Methodology for Detection of Mycobacteria in Pulmonary and Extrapulmonary Specimens by Smear Microscopy, Culture, and PCR J. Clin. Microbiol., June 1, 2005; 43(6): 2697 - 2702. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Chakravorty, M. Dudeja, M. Hanif, and J. S. Tyagi Utility of Universal Sample Processing Methodology, Combining Smear Microscopy, Culture, and PCR, for Diagnosis of Pulmonary Tuberculosis J. Clin. Microbiol., June 1, 2005; 43(6): 2703 - 2708. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Prabhakar, A. Mishra, A. Singhal, V. M. Katoch, S. S. Thakral, J. S. Tyagi, and H. K. Prasad Use of the hupB Gene Encoding a Histone-Like Protein of Mycobacterium tuberculosis as a Target for Detection and Differentiation of M. tuberculosis and M. bovis J. Clin. Microbiol., June 1, 2004; 42(6): 2724 - 2732. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. MIRZA, B. I. RESTREPO, J. B. MCCORMICK, and S. P. FISHER-HOCH DIAGNOSIS OF TUBERCULOSIS LYMPHADENITIS USING A POLYMERASE CHAIN REACTION ON PERIPHERAL BLOOD MONONUCLEAR CELLS Am J Trop Med Hyg, November 1, 2003; 69(5): 461 - 465. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Kidane, J. O. Olobo, A. Habte, Y. Negesse, A. Aseffa, G. Abate, M. A. Yassin, K. Bereda, and M. Harboe Identification of the Causative Organism of Tuberculous Lymphadenitis in Ethiopia by PCR J. Clin. Microbiol., November 1, 2002; 40(11): 4230 - 4234. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Rimek, S. Tyagi, and R. Kappe Performance of an IS6110-Based PCR Assay and the COBAS AMPLICOR MTB PCR System for Detection of Mycobacterium tuberculosis Complex DNA in Human Lymph Node Samples J. Clin. Microbiol., August 1, 2002; 40(8): 3089 - 3092. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Narayanan, V. Parandaman, P. R. Narayanan, P. Venkatesan, C. Girish, S. Mahadevan, and S. Rajajee Evaluation of PCR Using TRC4 and IS6110 Primers in Detection of Tuberculous Meningitis J. Clin. Microbiol., May 1, 2001; 39(5): 2006 - 2008. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
| Journal of Clinical Pathology | Molecular Pathology |
