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J Infect Public Health. 2014 Jul-Aug;7(4):251-6. doi: 10.1016/j.jiph.2013.11.002. Epub 2014 Mar 4.

The predictive value of Gen-Probe's amplified Mycobacterium tuberculosis direct test compared with culturing in paraffin-embedded lymph node tissue exhibiting granulomatous inflammation and negative acid fast stain.

Author information

1
Pathology Services Division, Dhahran Health Center, Saudi Aramco Medical Services Organization, Dhahran, Saudi Arabia. Electronic address: wasim.raslan@aramco.com.
2
Pathology Services Division, Dhahran Health Center, Saudi Aramco Medical Services Organization, Dhahran, Saudi Arabia.
3
Specialty Internal Medicine Unit, Dhahran Health Center, Saudi Aramco Medical Services Organization, Dhahran, Saudi Arabia.

Abstract

BACKGROUND AND OBJECTIVES:

The diagnosis of granulomatous inflammation with possible tuberculosis (TB) infection in histopathology is often difficult. There is a need for a rapid and reliable diagnostic test. Thus, we evaluated the performance of the Mycobacterium tuberculosis direct (MTD) test in specimens with granulomatous lymphadenitis and negative acid fast stains.

METHODS:

The M. tuberculosis direct (MTD) test by Gen-Probe was performed on 45 formalin-fixed paraffin-embedded tissue samples including 34 lymph nodes. We measured the predictive values of the MTD test in specimens with granulomatous lymphadenitis and negative acid fast stains.

RESULTS:

The overall test sensitivity was 73.9%, and specificity was 95.4%. The MTD test sensitivity and specificity for lymph node tissue were 72.7% and 91.67%, respectively. In the presence of granulomatous inflammation, the MTD test sensitivity and specificity were higher than those for all tissue samples, at 75% and 100%, respectively.

CONCLUSION:

Based on this study, the MTD test should be used as a supportive test in addition to conventional histochemical or immunological staining methods when evaluating lymph node tissue with a granulomatous inflammation to deliver stronger evidence to support clinical decisions at a much earlier time than a culture would allow.

KEYWORDS:

Gen-Probe; Granuloma; Molecular testing; Mycobacterium tuberculosis direct (MTD) test; Tuberculosis

PMID:
24602771
DOI:
10.1016/j.jiph.2013.11.002
[Indexed for MEDLINE]
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