Diagnostic tests for tuberculous lymphadenitis: fine needle aspirations using tissue culture in mycobacteria growth indicator tube and tissue PCR

Abstract Background: The diagnosis of tuberculous lymphadenitis (TBLN) ranges from therapeutic diagnosis to open biopsy with tissue culture. The open biopsies are accepted as the gold standard to diagnose TBLN, but it requires skin incision that leaves unwanted scars. Objective: Test the sensitivity and specificity of fine needle aspiration (FNA) using tissue culture in mycobacteria growth indicator tube (MGIT) and tissue polymerase chain reaction (PCR) for comparison with open biopsy using tissue culture. Subject and methods: Forty patients with clinically suspected cervical tuberculous lymphadenitis were recruited at King Chulalongkorn Memorial Hospital. The patients underwent FNA followed by open biopsies either excisional or incisional. Specimens from FNA were collected for tissue culture in MGIT and for tissue PCR. The specimens from open biopsies were divided into two portions for tissue culture in MGIT (the gold standard) and for hispathology. Results: FNA for tissue culture in MGIT had a moderate sensitivity (65%) but high specificity (83%) (73% positive and 76% negative predictive value). FNA for tissue PCR had a moderate sensitivity (53%) but very high specificity (96%) (90% positive and 73% negative predictive values). Combination of either FNA for tissue culture or FNA tissue PCR revealed an increase in sensitivity and specificity to 83.6% and 80.0%, respectively. However, a combination of both FNA for tissue culture and FNA tissue PCR revealed a decrease in sensitivity (34.5%) but a highly increase in specificity (99.0%). Conclusion: Either the FNA using tissue culture in MGIT or tissue PCR had a moderate sensitivity but high specificity. FNA using tissue culture or FNA tissue PCR may be used as an alternative test for diagnosis TBLN. The techniques may replace the open biopsies because of its effectiveness and low complication rate.

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Significance of Quadruple assessment of breast lump–A hospital based study

Journal of Pathology of Nepal ◽

10.3126/jpn.v4i8.11499 ◽

2014 ◽

Vol 4 (8) ◽

pp. 630-634

Author(s):

MK Shrestha ◽

D Ghartimagar ◽

A Ghosh ◽

E Shrestha ◽

P Bolar

Keyword(s):

Breast Cancer ◽

Sensitivity And Specificity ◽

Fine Needle Aspiration ◽

Gold Standard ◽

Fine Needle Aspiration Cytology ◽

Needle Aspiration ◽

Breast Lump ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology

Background: Approximately 10% of breast masses are breast cancer. It is important for women with a breast lump to receive appropriate evaluation. Mammography has been the “gold standard” in breast cancer detection for >40 years. Ultrasonography is non-invasive easily available, cheaper and accurate tool while Fine needle aspiration cytology has a high diagnostic accuracy rate in hands of experienced cytopathologist. Materials and methods: This was a retrospective and prospective study of 173 women attending radiology department in Manipal Teaching Hospital, Pokhara for mammography during a period of 18 months from January 2011 to June 2012.The age ranged from 20yrs to 75yrs. BIRADS score was given for both mammography and sonomammography. All malignant and suspicious cases had undergone fine needle aspiration cytology. Cytology reports were correlated with imaging study. Results: The most common age group for the breast lump was 40-49 years showing 65(37.57%) cases. Most lumps were seen on the left side 54.3% (94/ 173) cases and were seen in upper outer quadrant of the breast (74 cases). 11 cases each were given the BIRADS score of 4 in both mammography and sonomammography. Sensitivity and specificity of mammography and sonomammography were compared to cytologyreports. The sensitivity for mammogram was 73.7% while specificity was 96.3%. The sensitivity and specificity for sonomammogram was 78.9% and 95% respectively. Conclusion: Quadruple assessment i.e. clinical assessment, mammography, sonomammography and cytological study are the new “gold standard” in the investigation of breast disease. DOI: http://dx.doi.org/10.3126/jpn.v4i8.11499 Journal of Pathology of Nepal; Vol.4,No. 8 (2014) 630-634

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Cervical tuberculous lymphadenitis: diagnosis and demographics, a five-year case series in the UK

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2018.0021 ◽

2018 ◽

Vol 100 (5) ◽

pp. 392-396 ◽

Cited By ~ 4

Author(s):

D Moualed ◽

M Robinson ◽

A Qureishi ◽

P Gurr

Keyword(s):

Fine Needle Aspiration ◽

Delayed Diagnosis ◽

Case Series ◽

Needle Aspiration ◽

Tuberculous Lymphadenitis ◽

Open Biopsy ◽

Retrospective Case ◽

Full Data ◽

Fine Needle ◽

The Uk

Introduction Cervical tuberculous lymphadenitis is a low-volume condition in the UK with a potential for delayed diagnosis. This study describes typical demographic and clinical features of patients diagnosed with cervical tuberculous lymphadenitis in a UK population. The utility of cytological, histological and microbiological investigations is reviewed with comparison between fine-needle aspiration and open biopsy. This information can facilitate recognition of new cases and guide initial management. Methods Patients diagnosed with cervical tuberculous lymphadenitis between January 2009 and December 2013 at two district general hospitals were identified from local infectious disease databases. Retrospective case-note review was undertaken to collect demographic and diagnostic data and associated complications. Results Full data were available for 51 patients aged 19–70 years (mean 32.4 years) with mean follow-up of 370 days; 49/51 patients were immigrants to the UK with a wide geographic spread in the countries of origin and time since arrival; 42/51 had no significant comorbidities, although two patients had coexistent HIV infection. The clinical presentation was most frequently without constitutional symptoms (39/51) and often with no history of tuberculosis contact. Posterior triangle neck nodes were most commonly involved (26/51). Conclusion The ‘typical’ patient with cervical tuberculous lymphadenitis in our region is a young healthy individual who came to the UK from a high-risk country several years earlier. Diagnosis by fine-needle aspiration is as effective as open biopsy if fluid/pus is aspirated. Open biopsy is potentially associated with complications but does not appear to increase chronic wound discharge rates in our series.

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Evaluation of RNA extraction free method for detection of SARS-COV-2 in salivary samples for mass screening for COVID-19

10.1101/2021.03.15.21253570 ◽

2021 ◽

Author(s):

Sally A. Mahmoud ◽

Esra Ibrahim ◽

Subhashini Ganesan ◽

Bhagyashree Thakre ◽

Juliet G Teddy ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Gold Standard ◽

Rna Extraction ◽

High Sensitivity ◽

High Specificity ◽

Cost Effective ◽

Kappa Coefficient ◽

Nasopharyngeal Swab ◽

Rt Pcr ◽

Good Percentage

AbstractIn this current COVID - 19 pandemic, there is a dire need for cost effective and less time-consuming alternatives for SARS-COV-2 testing. The RNA extraction free method for detecting SARS-COV-2 in saliva is a promising option, this study found that it has high sensitivity (85.34%), specificity (95.04%) and was comparable to the gold standard nasopharyngeal swab. The method showed good percentage of agreement (kappa coefficient) 0.797 between salivary and NPS samples. However, there are variations in the sensitivity and specificity based on the RT-PCR kit used. The Thermo Fischer-Applied biosystems showed high sensitivity, PPV and NPV but also showed higher percentage of invalid reports. Whereas the BGI kit showed high specificity, better agreement (kappa coefficient) between the results of saliva and NPS samples and higher correlation between the Ct values of saliva and NPS samples. Thus, the RNA extraction free method for salivary sample serves as an effective alternative for SARS-CoV 2-testing.

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Preoperative Pet/Ct Findings in Endometrial Cancer: A Study of 30 Cases

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2016.657 ◽

2017 ◽

pp. 1

Author(s):

Duygu Altın ◽

Dila Zengin Kasapoğlu ◽

Zafer Selçuk Tuncer

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Sensitivity And Specificity ◽

High Specificity ◽

Node Metastasis ◽

Pet Ct ◽

Significant Difference ◽

Staging Surgery ◽

Moderate Sensitivity ◽

Stage 1

Objective: The aim of this study was to find out if preoperative PET/CT could be a substitute for staging surgery and whether SUVmax values correlate with prognostic factors of endometrium cancer. Study Design: 30 patients to whom18-fluorodeoxyglucose PET/CT scan was performed preoperatively were analyzed retrospectively. Standardized uptake value (SUV) was calculated on PET images. PET findings were compared with surgical and pathological findings. Results: SUVmax of the endometrioid type tumors were significantly higher than non-endometrioid types (p: 0.042). SUVmax significantly differ between histologic grades (p: 0.042). SUVmax did not differ between patients who had myometrial invasion less or more than 50% and who had lymphovascular invasion or not. There was not a significant difference between SUVmax and FIGO stages also. Possibility of extra-uterine lesion in PET/CT were significantly higher in late stages (p: 0.004). Sensitivity and specificity of PET/CT for detection of beyond stage 1 disease were 50% and 67% respectively and sensitivity and specificity of PET/CT for detection of lymph node metastasis were 40% and 86% respectively. Conclusion: PET/CT has moderate sensitivity for pre-operative detection of beyond stage 1 cancers but it has a high specificity and low-moderate sensitivity for detection of lymph node metastasis but has high specificity. Because the positive likelihood ratios are relatively low, PET/CT cannot be a substitute for staging surgery.

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Sensitivity and specificity of the antigen-based anterior nasal self-testing programme for detecting SARS-CoV-2 infection in schools, Austria, March 2021

Eurosurveillance ◽

10.2807/1560-7917.es.2021.26.34.2100797 ◽

2021 ◽

Vol 26 (34) ◽

Author(s):

Peter Willeit ◽

Benoît Bernar ◽

Christoph Zurl ◽

Mariam Al-Rawi ◽

Andrea Berghold ◽

...

Keyword(s):

Cohort Study ◽

Sensitivity And Specificity ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Representative Sample ◽

Screening Programme ◽

High Specificity ◽

Self Testing ◽

Moderate Sensitivity ◽

Very High

This study evaluates the performance of the antigen-based anterior nasal screening programme implemented in all Austrian schools to detect SARS-CoV-2 infections. We combined nationwide antigen-based screening data obtained in March 2021 from 5,370 schools (Grade 1–8) with an RT-qPCR-based prospective cohort study comprising a representative sample of 244 schools. Considering a range of assumptions, only a subset of infected individuals are detected with the programme (low to moderate sensitivity) and non-infected individuals mainly tested negative (very high specificity).

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Performance of the Present-on-Admission Indicator for Clostridium difficile Infection

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2015.63 ◽

2015 ◽

Vol 36 (7) ◽

pp. 838-840 ◽

Cited By ~ 5

Author(s):

Amy L. Pakyz ◽

Julie A. Patterson ◽

Christine Motzkus-Feagans ◽

Samuel F. Hohmann ◽

Michael B. Edmond ◽

...

Keyword(s):

Clostridium Difficile ◽

Sensitivity And Specificity ◽

Administrative Data ◽

Clostridium Difficile Infection ◽

High Specificity ◽

Infect Control Hosp ◽

Clinical Surveillance ◽

Moderate Sensitivity ◽

Present On Admission ◽

Community Onset

The performance of a hospital- and community-onset Clostridium difficile infection definition using administrative data with a present-on-admission indicator was compared with definitions using clinical surveillance. For hospital-onset C. difficile infection, there was moderate sensitivity (68%) and high specificity (93%); for community-onset, sensitivity and specificity were high (both 85%).Infect Control Hosp Epidemiol 2015;36(7):838–840

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Diagnostic accuracy of tuberculous lymphadenitis fine needle aspiration biopsy confirmed by PCR as gold standard

IOP Conference Series Earth and Environmental Science ◽

10.1088/1755-1315/125/1/012048 ◽

2018 ◽

Vol 125 ◽

pp. 012048

Author(s):

DSuryadi ◽

Delyuzar ◽

Soekimin

Keyword(s):

Diagnostic Accuracy ◽

Fine Needle Aspiration ◽

Gold Standard ◽

Fine Needle Aspiration Biopsy ◽

Needle Aspiration ◽

Aspiration Biopsy ◽

Tuberculous Lymphadenitis ◽

Fine Needle ◽

Needle Aspiration Biopsy

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Axillary fine needle aspiration cytology for pre-operative staging of patients with screen-detected invasive breast carcinoma

Journal of Clinical Pathology ◽

10.1136/jcp.2010.084772 ◽

2011 ◽

Vol 64 (4) ◽

pp. 338-342 ◽

Cited By ~ 9

Author(s):

Brian D Hayes ◽

Linda Feeley ◽

Cecily M Quinn ◽

M M Kennedy ◽

Ann O'Doherty ◽

...

Keyword(s):

Lymph Nodes ◽

High Specificity ◽

Needle Aspiration ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Aspiration Cytology ◽

Fine Needle ◽

Node Biopsy ◽

Moderate Sensitivity ◽

Needle Aspiration Cytology

IntroductionFine needle aspiration cytology (FNAC) of radiologically abnormal axillary lymph nodes in patients with breast cancer can identify patients suitable for primary axillary clearance (AC) rather than sentinel node biopsy, enabling surgical axillary staging by a single operation. This study assessed the accuracy of FNAC in predicting positive axillary lymph nodes.Methods161 patients with screen-detected invasive carcinoma and who had pre-operative FNAC of a radiologically abnormal axillary lymph node were identified from two screening units, The axillary FNAC reports were correlated with sentinel node biopsy and AC reports, and sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated.ResultsFNAC had a moderate sensitivity (66.3%) and NPV (71.8%), and a high specificity (98.7%) and PPV (98.3%). Most patients (86%) had a single axillary operation. The sensitivity was highest in grade 3 (81.8%) and ductal type (77.8%) tumours. The sensitivity was lower in tumours of special type (34.8%), grade 1 tumours (50%) and those without lymphovascular invasion (LVI) (55.9%). The NPV was highest in pT1 (86.7%) and in grade 1 (84.5%) tumours, and lowest (44%) in tumours with LVI. The PPV was 100% in grade 1 and 3 tumours, stage pT2 and pT3 tumours and those without LVI, and was high (>96%) in all other groups. In lymph-node-positive patients, the mean number of lymph nodes involved was higher in the case of a positive (6.4) than negative FNAC (4.4).ConclusionsFNAC of ultrasonically abnormal axillary lymph nodes achieved surgical staging by a single operation in most patients with screen-detected invasive breast carcinoma, with moderate sensitivity and high specificity.

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Percutaneous Imaging-Guided versus Open Musculoskeletal Biopsy: Concepts and Controversies

Seminars in Musculoskeletal Radiology ◽

10.1055/s-0040-1717113 ◽

2020 ◽

Vol 24 (06) ◽

pp. 667-675

Author(s):

Violeta Vasilevska Nikodinovska ◽

Slavcho Ivanoski ◽

Milan Samardziski ◽

Vesna Janevska

Keyword(s):

Soft Tissue ◽

Complication Rate ◽

Core Needle Biopsy ◽

Multidisciplinary Team ◽

Gold Standard ◽

Needle Biopsy ◽

Soft Tissue Tumors ◽

Open Biopsy ◽

Core Needle ◽

Similar Accuracy

AbstractBone and soft tissue tumors are a largely heterogeneous group of tumors. Biopsy of musculoskeletal (MSK) tumors is sometimes a challenging procedure. Although the open biopsy is still considered the gold standard for the biopsy of MSK lesions, core needle biopsy can replace it in most cases, with similar accuracy and a low complication rate. The biopsy should be performed in a tertiary sarcoma center where the multidisciplinary team consists of at minimum a tumor surgeon, an MSK pathologist, and an MSK radiologist who can assess all steps of the procedure. Several factors can influence the success of the biopsy including the lesion characteristics, the equipment, and the method used for the procedure. This review highlights some of the important aspects regarding the biopsy of the MSK tumors, with special attention to imaging a guided core needle biopsy and highlighting some of the recent advancements and controversies in the field.

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