A Comparative Study of Cartridge-based Nucleic Acid Amplification Test, Histopathological Examination, and Culture and Sensitivity in Suspicious Cases of Tubercular Lymphadenopathy

Manish Kaushal; Arvind Shukla; Arvind Ghanghoria; Manisankar Das; Khushal Rao Hurmade; Deepak Shukla

Manish Kaushal M.G.M. Medical College & M.Y.H. Hospital, Indore, Madhya Pradesh India
Arvind Shukla M.G.M. Medical College & M.Y.H. Hospital, Indore, Madhya Pradesh, India
Arvind Ghanghoria M.G.M. Medical College & M.Y.H. Hospital, Indore, Madhya Pradesh, India
Manisankar Das M.G.M. MedicalCollege and M.Y.H. Hospital, Indore, Madhya Pradesh, India
Khushal Rao Hurmade M.G.M. MedicalCollege and M.Y.H. Hospital, Indore, Madhya Pradesh, India
Deepak Shukla M.G.M. MedicalCollege and M.Y.H. Hospital, Indore, Madhya Pradesh, India

Keywords: Tuberculosis,, Cartridge-based nucleic acid amplification test,, Histopathology,, Rifampicin,, Lowenstein Jensen culture

Abstract

Introduction: Tuberculosis (TB) is one of the most important diseases in the history of mankind and remains as an extraordinary
burden to humanity even today. Tuberculous lymphadenitis (TBLN) is the most common extrapulmonary TB which accounts for
25–30% of TB cases. Lymph node (LN) TB is frequent among HIV infected patients. TBLN, abdominal, or cervical is caused
largely due to Mycobacterium tuberculosis which was once caused by Mycobacterium bovis. In this study, we evaluated the
performance of cartridge-based Nucleic Acid Amplification Test (CB-NAAT) for the diagnosis of TBLN on histopathological
examination (HPE) of excisional LN biopsy and culture and sensitivity.
Aims and Objective: (1) The objective of the study was to evaluate and compare three modalities, that is, CBNAAT, HPE and
Culture and Sensitivity for diagnosis of TB in cases of lymphadenopathy, (2) sensitivity and specificity of each modality, (3) to
assess efficacy of CBNAAT over other modality, and (4) to identify Rifampicin-resistant cases.
Materials and Methods: Enlarged LN is biopsied. One part of this material was put in a sterile container and sent for CB-NAAT
and the other part was smeared on 2–3 slides and send for Lowenstein Jensen culture. Third part of the biopsy sample taken
in sterile container with 10% formalin sent for HPE.
Result: CBNAAT is the most sensitive technique. As the rate of drug resistant TB is in increasing trend, it is essential to use a
rapid method which detects M. tuberculosis and rifampicin resistance simultaneously. Thus, CBNAAT is the best method in the
diagnosis of TB. Earlier detection can reduce the death rate and prevent the spread of TB in the community.

Author Biographies

Manish Kaushal, M.G.M. Medical College & M.Y.H. Hospital, Indore, Madhya Pradesh India

Professor, Department of Surgery

Arvind Shukla, M.G.M. Medical College & M.Y.H. Hospital, Indore, Madhya Pradesh, India

Associate Professor,Department of Surgery

Arvind Ghanghoria, M.G.M. Medical College & M.Y.H. Hospital, Indore, Madhya Pradesh, India

Professor and Head, Department of Surgery

Manisankar Das, M.G.M. MedicalCollege and M.Y.H. Hospital, Indore, Madhya Pradesh, India

Junior Resident, Department of Surgery

Khushal Rao Hurmade, M.G.M. MedicalCollege and M.Y.H. Hospital, Indore, Madhya Pradesh, India

Junior Resident, Department of Surgery

Deepak Shukla, M.G.M. MedicalCollege and M.Y.H. Hospital, Indore, Madhya Pradesh, India

Junior Resident, Department of Surgery

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