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Cytodiagnosis of tuberculosis using modified bleach method on lymph node aspirates
Sarah Khan1, Hemalata Mahantappa1, Anagha A Joshi1
1Department of Pathology, Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India.
Journal of Oral and Maxillofacial Pathology : JOMFP
|August 31, 2018
Summary
The bleach method enhances the detection of acid-fast bacilli (AFB) in fine-needle aspiration samples for tuberculosis diagnosis. This improved microscopic detection offers a valuable alternative to the conventional Ziehl-Neelsen staining method.
Area of Science:
- Microbiology
- Medical Diagnostics
- Pathology
Background:
- Conventional Ziehl-Neelsen (ZN) staining is crucial for diagnosing tuberculosis via acid-fast bacilli (AFB) detection.
- However, the ZN method suffers from low sensitivity, potentially leading to missed diagnoses.
Purpose of the Study:
- To evaluate the efficacy of the bleach concentration method compared to the conventional ZN smear.
- The study focused on detecting AFB in fine-needle aspiration (FNA) material from patients with suspected tuberculous lymphadenitis.
Main Methods:
- A cross-sectional study was conducted on 150 patients with clinically suspected tuberculous lymphadenitis.
- Fine-needle aspirates (FNAs) were processed for routine cytology and conventional ZN staining.
- The bleach method was applied to the remaining aspirate material for AFB detection.
Main Results:
- Cytology indicated tuberculosis in 57% (85/150) of cases.
- Conventional ZN staining detected AFB in 37% (55/150) of samples.
- The bleach method increased smear positivity for AFB to 41% (62/150).
Conclusions:
- The bleach method offers a simple, safe, and cost-effective approach for AFB detection.
- It significantly improves the microscopic identification of AFB compared to the conventional ZN method.
- This technique can be a valuable addition to routine cytological analysis for tuberculosis diagnosis.
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