Original Research Article
Year: 2020 | Month: July | Volume: 10 | Issue: 7 | Pages: 17-21
Rapid Diagnosis of Tubercular Lymphadenopathy by Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) and its Correlation with Ziehl-Neelsen Staining on Fine Needle Aspiration Cytology
Manju Kumari1, Poonam Khambra2, Kirti Panwar1, Indu Yadav3
1Senior Resident, 2Assistant Professor, 3Specialist and Assistant Professor,
Department of Pathology, VMMC and Safdarjung Hospital, New Delhi-110023, India
ABSTRACT
Introduction: Tuberculosis is a leading cause of morbidity and mortality in India with an incidence of 2.74 million including 0.13 million drug resistant cases. There were 0.41 deaths in India in 2017. An early diagnosis is required for treatment and control of infection. Conventional microscopy and Ziehl-Neelsen (Z-N) staining has low sensitivity in cervical tuberculosis due to paucicellular nature of the disease. Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) has a well established role in detection of pulmonary tuberculosis. Recently, WHO has recommended its use in extrapulmonary tuberculosis as an initial diagnostic tool.
Material and Methods: This is a prospective study performed in department of pathology and included 100 patients of suspected recurrence of tubercular lymphadenopathy. Fine needle aspiration was done and the material was sent for CBNAAT. The rest of the material was used for preparing giemsa stained and Z-N stained smears. Of these, 24 cases were positive for acid fast bacilli (AFB) by microscopy and Z-N stain while 41 cases were positive for tuberculosis by CBNAAT indicating a higher sensitivity of CBNAAT. This difference was statistically significant (p value <0.05)
Conclusion: CBNAAT is more sensitive for detection of recurrent cervical tuberculosis in comparison to conventional microscopy and ZN staining. This should be used as an initial diagnostic tool for recurrent tubercular cases in countries with high prevalence like India.
Key words: recurrent, tubercular lymphadenopathy, CBNAAT, Ziehl-Neelsen stain, Fine needle aspiration.