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Cited by 31Diagnosis and treatment of tuberculosisLymphadenopathy Diagnosis and AnalysisTuberculosis Research and Epidemiology

Diagnosis of tuberculous lymphadenitis using fine needle aspiration biopsy

Knox, J., Lane, G., Wong, J. S. J., Trevan, P. G., Karunajeewa, H.·2012·Internal Medicine Journal
DOI 10.1111/j.1445-5994.2012.02748.x
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Abstract

BACKGROUND: Tuberculous lymphadenitis is the commonest form of extrapulmonary tuberculosis. However, the optimal approach to diagnosis, employing biopsy by either fine needle aspiration (FNA) or surgical excision, remains uncertain. AIMS: To evaluate the diagnostic value of biopsy using each of the component diagnostic modalities of FNA (microscopy, cytology and culture), and compare these with excision biopsy in the diagnosis of tuberculous lymphadenitis in a predominantly migrant population in Melbourne. METHODS: A retrospective examination of tuberculous lymphadenitis cases presenting to Western Health over 12 years was conducted. Using a reference method of positive culture of Mycobacterium tuberculosis, the diagnostic sensitivities of each modality employed in FNA were determined. RESULTS: Forty-two subjects having FNA and 30 having excision biopsy as the initial investigation were compared. Among specimens obtained by FNA, sensitivity of microscopy was 18% (95% confidence interval (CI): 5–40%) and sensitivity of cytology was 38% (95% CI: 20–59%). For specimens obtained by excision biopsies, sensitivities for microscopy and histology were 17% (95% CI: 2–32%) and 96% (95% CI: 88–100%) respectively. Sensitivity of culture performed on FNA specimens was 86% (95% CI: 65–97%). CONCLUSIONS: Given the relatively high sensitivity of mycobacterial cultures from FNA, this study supports its routine use as the initial investigation in most patients with suspected tuberculous lymphadenitis. Microscopy and cytology add relatively little to the clinical utility of FNA

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  • M tuberculosis lineage strains are associated with the site of tuberculosis disease; strains mostly distributed through Southeast Asia and the Indian Subcontinent (such as M tuberculosis Beijing/W strain) are more likely to cause extrapulmonary disease.

    “A few studies have shown that M tuberculosis lineage strains are associated with the site of tuberculosis disease. The strains mostly distributed through Southeast Asia and the Indian Subcontinent (such as M tuberculosis Beijing/W strain) are more likely to cause extrapulmonary disease.9–11”

    From Epidemiology and Diagnosis of Tuberculous Lymphadenitis in a Tuberculosis Low-Burden Country (2015) · cites this paper as [11]

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Authors
Knox, J., Lane, G., Wong, J. S. J., Trevan, P. G., & Karunajeewa, H.
Affiliations
  • The Royal Melbourne Hospital (AU)
  • Department of Health and Human Services (AU)
  • Western Health (AU)
Corresponding author
Karunajeewa, H.
ORCID
Karunajeewa, H.
Venue
Internal Medicine Journal
Publisher
Wiley
Published
2012-09
Volume
42
Issue
9
Pages
1029-1036
ISSN
  • 1444-0903 (ISSN-L)
  • 1445-5994
DOI
10.1111/j.1445-5994.2012.02748.x
OpenAlex
W2141826262
Cited by
31
References
29
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 5 · 2022: 2 · 2021: 3 · 2019: 3 · 2018: 2 · 2016: 2 · 2015: 5 · 2014: 3 · 2012: 3
FWCI
3.58
Type
journal article
Language
en
Open access
closed
Licence
doi.wiley.com/10.1002/tdm_license_1 (tdm)
Locations
  • Internal Medicine Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Diagnosis and treatment of tuberculosis
  • Health Sciences › Medicine › Surgery › Lymphadenopathy Diagnosis and Analysis
  • Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
Keywords
tuberculous lymphadenitis, fine-needle aspiration, excisional biopsy, extrapulmonary tuberculosis, Mycobacterium tuberculosis culture, microscopy, cytology, diagnostic sensitivity, migrants
MeSH terms
Adult, Cytological Techniques, Female, Humans, Male, Microscopy, Middle Aged, Mycobacterium tuberculosis, Retrospective Studies, Sensitivity and Specificity, Staining and Labeling, Tuberculosis, Lymph Node, Victoria, HIV Infections, Comorbidity, Biopsy, Fine-Needle

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