Published date: Sep 30 2022

Journal Title: Sudan Journal of Medical Sciences

Issue title: Sudan JMS: Volume 17 (2022), Issue No. 3

Pages: 330–340

DOI: 10.18502/sjms.v17i3.12103

Omar MustafaDepartment of Histopathology and Cytology, College of Medical Laboratories Science, University of Medical Science and Technology (UMST)

Ebtehal MohamedDepartment of Clinical Chemistry, College of Medical Laboratory Science, Al-Neelain University

Ahmed OmerDepartment of Clinical Chemistry, College of Medical Laboratory Science, Al-Neelain University

Abdelmonem MohamedDepartment of Clinical Chemistry, College of Medical Laboratory Science, Al-Neelain University

Sheima AbdemagidDepartment of Microbiology, College of Medical laboratory science, University of Alzaiem Al Azhari

Alaa AliDepartment of Hematology and Immunohematology, College of Medical Laboratory Science, Sudan University of Science and Technology

Nafisa HassanDepartment of Clinical Chemistry, College of Medical Laboratory Science, University of El imam El Mahdi

Mayada KhalilDepartment of Medical Microbiology, College of Medical Laboratory Science, University of Gezira

Nagia Sulimannagisuliman@hotmail.comDepartment of Medical Microbiology, College of Medical Laboratory Science, University of Gezira

Background: Tuberculosis (TB) is a major healthcare burden in Sudan and other developing countries, it is considered the second most common cause of death from infectious diseases after those due to AIDS. In Sudan, TB lymphadenitis (TBLA) remains one of the major health problems. This descriptive cross-sectional study was conducted at the University of Medical Sciences and Technology (UMST) and Total Labcare Diagnostic Center (TDC). The study aims to compare the sensitivity of Fine Needle Aspiration Cytology (FNAC) smears with that of the Polymerase Chain Reaction (PCR) for the diagnosis of TBLA.

Materials and Methods: Fifty-five dry smears were obtained using fine-needle aspiration (FNA) from an enlarged lymph node. PCR was applied to detect the target gene (IS6110). May-Grunwald-Giemsa (MGG) or Diff quick stains were used.

Results: Two (4%) patients with TBLA were non-necrotic, while fifty-three of them (96%) were necrotic. Moreover, 17 (30%) fine-needle lymph node aspiration specimens were confirmed by PCR to be positive for Mycobacterium tuberculosis complex (MTB complex) while 38 (70%) of them were negative.

Conclusion: There was no significant difference between the sensitivity of PCR and that of FNAC (P-value = 0.33).

Keywords: tuberculosis, lymphadenitis, lymph node, FNAC, PCR

[1] Mittal, P., Handa, U., Mohan, H., & Gupta, V. (2011). Comparative evaluation of fine needle aspiration cytology, culture, and PCR in diagnosis of tuberculous lymphadenitis. Diagnostic Cytopathology, 39, 822–826. https://doi.org/10.1002/dc.21472

[2] Zammarchi, L., Bartalesi, F., & Bartoloni, A. (2014). Tuberculosis in tropical areas and immigrants. Mediterranean Journal of Hematology and Infectious Diseases, 6(1), e2014043. https://doi.org/10.4084/mjhid.2014.043

[3] CDC. (2020). Tuberculosis. CDC. https://www.cdc.gov/globalhealth/newsroom/topics/tb/index.

[4] Chatterjee, D., & Pramanik, A. K. (2015). Tuberculosis in the African continent: A comprehensive review. Pathophysiology, 22(1), 73–83. https://doi.org/10.1016/j.pathophys.2014.12.005

[5] Abdallah, T. M., & Ali, A. A. (2012). Epidemiology of tuberculosis in Eastern Sudan. Asian Pacific Journal of Tropical Biomedicine, 2(12), 999–1001. https://doi.org/10.1016/S2221-1691(13)60013-1

[6] WHO. (2015). Sudan / Tuberculosis. WHO. http://www.emro.who.int/sdn/ programmes/stop-tb-sudan.html

[7] Hwang, S. H., Kim, D. E., Sung, H., Park, B. M., Cho, M. J., Yoon, O. J., & Lee, D. H. (2015). Simple detection of the IS6110 sequence of Mycobacterium tuberculosis complex in sputum, based on PCR with graphene oxide. PLoS One, 10(8), e0136954. https://doi.org/10.1371/journal.pone.0136954

[8] Narayana Reddy, R. A., Narayana, S. M., & Shariff, S. (2013). Role of fine-needle aspiration cytology and fluid cytology in extra-pulmonary tuberculosis. Diagnostic Cytopathology, 41, 392-398. https://doi.org/10.1002/dc.22827

[9] Lazarus, A. A., & Thilagar, B. (2007). Tuberculous lymphadenitis. Disease-a-Month, 53(1), 10–15. https://doi.org/10.1016/j.disamonth.2006.10.001

[10] Mohapatra, P. R., & Janmeja, A. K. (2009). Tuberculous lymphadenitis. The Journal of the Association of Physicians of India, 57, 585–590.

[11] Patwardhan, S. A., Bhargava, P., Bhide, V. M., & Kelkar, D. S. (2011). A study of tubercular lymphadenitis: A comparison of various laboratory diagnostic modalities with a special reference to tubercular polymerase chain reaction. Indian Journal of Medical Microbiology, 29(4), 389–394. https://doi.org/10.4103/0255-0857.90173

[12] Rathod, G. B., & Parmar, P. (2012). Fine needle aspiration cytology of swellings of head and neck region. Indian Journal of Medical Sciences, 66(3–4), 49–54. https://doi.org/10.4103/0019-5359.110896

[13] Wakely, P. E., Jr., & Cibas, E. S. (2009). Chapter 11 - Lymph nodes. In: E. S. Cibas & B. S. Ducatman (Eds.). Cytology (3rd ed.). (319–357). Science Direct. https://doi.org/10.1016/B978-1-4160-5329-3.00011-6

[14] Caetano-Anolles, D. (2013). Polymerase chain reaction. In: S. Maloy & K. Hughes (Eds.). Brenner’s encyclopedia of genetics brenner’s encyclopedia of genetics (2nd ed.). (392–395). Academic Press. https://doi.org/10.1016/B978-0-12-374984-0.01186-4

[15] Hwang, S. H., Kim, D. E., Sung, H., Park, B. M., Cho, M. J., Yoon, O. J., & Lee, D. H. (2015). Simple detection of the IS6110 sequence of Mycobacterium tuberculosis complex in sputum, based on PCR with graphene oxide. PLoS One, 10(8), e0136954. https://doi.org/10.1371/journal.pone.0136954

[16] Lorenz, T. C. (2012). Polymerase chain reaction: Basic protocol plus troubleshooting and optimization strategies. Journal of Visualized Experiments, e3998(63), e3998. https://doi.org/10.3791/3998

[17] Chantranuwat, C., Assanasen, T., Shuangshoti, S., & Sampatanukul, P. (2006). Polymerase chain reaction for detection of Mycobacterium tuberculosis in papanicolaou-stained fine needle aspirated smears for diagnosis of cervical tuberculous lymphadenitis. The Southeast Asian Journal of Tropical Medicine and Public Health, 37(5), 940–947.

[18] Tansuphasiri, U., Boonrat, P., & Rienthong, S. (2004). Direct identification of Mycobacterium tuberculosis from sputum on Ziehl-Neelsen acid fast stained slides by use of silica-based filter combined with polymerase chain reaction assay. Journal of the Medical Association of Thailand, 87(2), 180–189.