Histopathology as a Diagnosis Tool of Abdominal Tuberculosis: A Narrative Review of Evidence

Abdominal tuberculosis (ATB) poses significant diagnostic challenges due to its varied clinical manifestations and its ability to mimic other diseases. Histopathology is a promising diagnostic tool to diagnose ATB. This narrative review aims to synthesize evidence on the evolving role of histopathology in diagnosing ATB, highlighting its integration with molecular and microbiological diagnostics, and discussing its limitations and emerging technologies.

A structured search of databases including PubMed, Scopus, Web of Science, and Google Scholar was performed, focusing on literature published from January 2002. The review includes peer-reviewed original articles on the diagnosis of ATB using histopathology and integrated diagnostic modalities.

Histopathology remains crucial for diagnosing ATB, especially in resource-limited settings, due to its ability to visualize granulomatous inflammation and other cellular features. The integration of histopathology with molecular diagnostics like GeneXpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) and tuberculosis polymerase chain reaction (TB-PCR) has improved diagnostic accuracy. However, limitations include diagnostic overlap with other conditions and the impact of prior treatment on tissue samples. Emerging technologies such as digital pathology and artificial intelligence (AI)-driven image analysis are poised to enhance diagnostic precision.

The review underscores the importance of a multimodal diagnostic approach, combining histopathology with other techniques to improve sensitivity and specificity. As ATB continues to be a global health concern, advancements in histopathological techniques and interdisciplinary collaboration are essential for timely and accurate diagnosis.