A Comparative Study of Diagnostic Tests for Thber
culous Lymphadenitis : Polymerase Chain Reaction vs
Histopathology and Clinical Diagnosis
PRAKOBKIAT HIRUNWIWATKUL, M.D.*, SOMYING TUMWASORN, M.Sc., Ph.D.**,
CHA VIT CHANTRANUW AT, M.D.***, UKKAPORN SIRICHAI, M.D.*
Affiliation : * Department of Otolaryngology,
** Department of Microbiology,
*** Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
AbstractTo compare diagnostic tests for tuberculous lymphadenitis by polymerase chain reaction
(PCR) with histopathology and clinical diagnosis in sensitivity, specificity and predictive value.
This retrospective analytic, single blind study was done at King Chulalongkom Memorial Hospital.
Paraffin-embedded specimens were classified into 2 groups. The study group contained 30 proved
AFB positive paraffin-embedded specimens from patients who also had clinical diagnosis of tuber
culosis and improved by antituberculous treatment. The control group contained 30 formalin-fixed,
paraffin-embedded specimens of lymph node hyperplasia proved by histopathological and clinical
review. All 60 specimens were slided, and systematically labeled and sent to PCR lab. Polymerase
Chain Reaction method had sensitivity = 43.33 per cent, specificity = 100 per cent, positive pre
dictive value =100 per cent and negative predictive value = 63.83 per cent. The present findings
revealed that the PCR results were related to the age of the paraffin-embedded tissues. No positive
results were obtained from tissues kept since 1996. Positive results were obtained in 317 cases
(42.86%), 2/3 (66.67%) and 8/lO cases (80%) from tissue of 1997, 1998 and 1999 respectively.
Conclusion : Polymerase chain reaction has sufficient reliability best as a confirmatory
diagnostic test for tuberculous lymphadenitis; however, it is not appropriate as a screening test.
Keywords : Tuberculous Lymphadenitis, Polymerase Chain Reaction, Histopathology, Clinical
Diagnosis
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