GYRB – POLYMERASE CHAIN REACTION AND HISTOPATHOLOGIC CHARACTERISTIC FIGURE POTENTIAL FOR DETERMINING DIAGNOSIS OF TUBERCULOUS LYMPHADENITIS
Keywords:EPTB, FNAB aspirate, gyrB, PCR, Tuberculosis, Tuberculous lymphadenitis
Background: TB lymphadenitis is still a problem that needs serious treatment. In Indonesia, it was reported that 53% of TB cases were extrapulmonary tuberculosis, with the most cases being Lymphadenitis TB, 11.6%. In children, 43% of extrapulmonary tuberculosis cases are TB lymphadenitis. Diagnosis is quite difficult; a method of determining the diagnosis and appropriate comprehensive treatment is required in managing TB Lymphadenitis.
Materials and Methods: In this study, 15 fine needle aspiration biopsy aspirate samples were subjected to molecular examination using the gyrB–polymerase chain reaction method and histopathological observations using the smear method with hematoxylin-eosin staining. Observation of preparations using a microscope with a magnification of 200x.
Results: The histopathological characteristics of the fine needle aspiration biopsy aspirate showed positive results in 4 out of 15 samples, with epithelioid cells arranged in a characteristic granuloma structure, necrotic debris was visible, and cells joined together to form multinucleated giant cells as an inflammatory response to complex infection. In this study, 6 out of 15 (40%) were detected to be positive in the diagnosis based on molecular detection using a specific target gene gyrB - polymerase chain reaction.
Conclusion: Characteristic features on histopathological examination associated with gyrB - positive polymerase chain reaction on lymphadenitis fine needle aspiration biopsy aspirate samples can be used as a determinant diagnosis of tuberculous lymphadenitis.
Anggraini, D., and Oktora, M. Z. (2021). “Hematology Profile of Tuberculosis Lymphadenitis Patients at Siti Rahmah Hospital, Padang, Indonesia.” Indonesian Journal of Clinical Pathology and Medical Laboratory; 27 (3): 271–75.
Arbind, A., D′souza, M., Jaimini, A., Saw, S., Solanki, Y., and Sharma, R. (2016). “Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Response Monitoring of Extrapulmonary Tuberculosis.” Indian Journal of Nuclear Medicine; 31 (1): 59.
Baykan, A. H., Sayiner, H. S., Aydin, E., Koc, M., Inan, I., and Erturk, S. M. (2022). “Extrapulmonary Tuberculosıs: An Old but Resurgent Problem.” Insights into Imaging; 13 (1): 39.
Chakravorty, S., Sen, M. K., and Tyagi, J. S. (2005). “Diagnosis of Extrapulmonary Tuberculosis by Smear, Culture, and PCR Using Universal Sample Processing Technology.” Journal of Clinical Microbiology; 43 (9): 4357–62.
Chang, C. Y., Hong, J. Y., Yuan, M. K., Chang, S. J., Lee, Y. M., Chang, S. C., Hsu, L. C., and Cheng, S. L. (2013). Risk factors in patients with AFB smear-positive sputum who receive inappropriate antituberculous treatment. Drug design, development and therapy; 7, 53–58.
Coetzee, L., Nicol, M. P., Jacobson, R., Schubert, P. T., van Helden, P. D., Warren, R. M., and Wright, C. A. (2014). “Rapid Diagnosis of Pediatric Mycobacterial Lymphadenitis Using Fine Needle Aspiration Biopsy.” Pediatric Infectious Disease Journal; 33 (9): 893–96.
Djannah, F., Massi, M. N., Hatta, M., Bukhari, A., and Hasanah, I. (2022). “Profile and Histopathology Features of Top Three Cases of Extra Pulmonary Tuberculosis (EPTB) in West Nusa Tenggara: A Retrospective Cross-Sectional Study.” Annals of Medicine and Surgery; 75 (March): 103318.
Gautam, H., Agrawal, SK., Verma, SK., and Singh, UB. (2018). “Cervical Tuberculous Lymphadenitis: Clinical Profile and Diagnostic Modalities.” International Journal of Mycobacteriology; 7 (3): 212.
Gopalaswamy, R., Dusthackeer, V. N. A., Kannayan, S., and Subbian, S. (2021). “Extrapulmonary Tuberculosis—An Update on the Diagnosis, Treatment and Drug Resistance.” Journal of Respiration; 1 (2): 141–64.
Kashyap, A., Singh, P. K., and Silakari, O. (2018). “Chemical Classes Targeting Energy Supplying GyrB Domain of Mycobacterium Tuberculosis.” Tuberculosis; 113 (December): 43–54.
Kiral, N., Caglayan, B., Salepci, B., Parmaksiz, E. T., Fidan, A., Comert, S. S., Yavuzer, D., and Partal, M. (2015). “Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Diagnosing Intrathoracic Tuberculous Lymphadenitis.” Medical Ultrasonography; 17 (3): 333.
Ko, Y., Kim, C., Park, Y., Mo, E. K., Moon, J. W., Park, S., Sim, Y., Hong, J., and Baek, M. (2019). “Clinical Characteristics and Treatment Outcomes of Definitive versus Standard Anti-Tuberculosis Therapy in Patients with Tuberculous Lymphadenitis.” Journal of Clinical Medicine; 8 (6): 813.
Kudu, A. T. D., Iliya, S., Atanda, A. T., Ismail, N. A., and Shehe, A. A. (2020). “Diagnosis of Extrapulmonary Tuberculosis by MTB/RIF from a Fine Needle Aspirate Biopsy: Case Report.” Journal of Microbiology and Infectious Diseases; 10(1) 59–61.
Ligthelm, L. J., Nicol, M. P., Hoek, K. G. P., Jacobson, R., van Helden, P. D., Marais, B. J., Warren, R. M., and Wright, C. A. (2011). “Xpert MTB/RIF for Rapid Diagnosis of Tuberculous Lymphadenitis from Fine-Needle-Aspiration Biopsy Specimens.” Journal of Clinical Microbiology; 49 (11): 3967–70.
Minnies, S., Reeve, B. W. P. Rockman, L., Nyawo, G., Naidoo, C. C., Kitchin, N.,and Rautenbach, C. (2021). “Xpert MTB/RIF Ultra Is Highly Sensitive for the Diagnosis of Tuberculosis Lymphadenitis in a High-HIV Setting.” Edited by Christine Y. Turenne. Journal of Clinical Microbiology; 59 (12): 1-11.
Petrella, S., Capton, E., Raynal, B., Giffard, C., Thureau, A., Bonneté, F., Alzari, P. M., Aubry, A., and Mayer, C. (2019). “Overall Structures of Mycobacterium Tuberculosis DNA Gyrase Reveal the Role of a Corynebacteriales GyrB-Specific Insert in ATPase Activity.” Structure; 27 (4): 579-589.e5.
Rodriguez-Takeuchi, Yukie, S., Renjifo, M. E., and Medina, F. J. (2019). “Extrapulmonary Tuberculosis: Pathophysiology and Imaging Findings.” RadioGraphics; 39 (7): 2023–37.
Sarfaraz, S., Iftikhar, S., Memon, Y., Zahir, N., Hereker, F. F., and Salahuddin, N. (2018). “Histopathological and Microbiological Findings and Diagnostic Performance of GeneXpert in Clinically Suspected Tuberculous Lymphadenitis.” International Journal of Infectious Diseases; 76 (1): 73–81.
Singh, K. K. (2000). “Comparison of in House Polymerase Chain Reaction with Conventional Techniques for the Detection of Mycobacterium Tuberculosis DNA in Granulomatous Lymphadenopathy.” Journal of Clinical Pathology; 53 (5): 355–61.
Sinha, P., Gupta, A., Prakash, P., Anupurba, S., Tripathi, R., and Srivastava, G. N. (2016). “Differentiation of Mycobacterium Tuberculosis Complex from Non-Tubercular Mycobacteria by Nested Multiplex PCR Targeting IS6110, MTP40 and 32kD Alpha Antigen Encoding Gene Fragments.” BMC Infectious Diseases; 16 (1): 123.
Soekotjo, F. N., Sudarwati, S., and Alam, A. (2019). “Clinical Profile of TB in Children at Pediatric Outpatient Clinic Hasan Sadikin Hospital Bandung 2016.” Journal of Medicine & Health; 2 (3): 818-827
Willemse, S. H., Oomens, M. A. E. M., De Lange, J., and Karssemakers, L. H. E. (2018). “Diagnosing Non-tuberculous Mycobacterial Cervicofacial Lymphadenitis in Children: A Systematic Review.” International Journal of Pediatric Otorhinolaryngology; 112 (1): 48–54
World Health Organization. (2021). Global Tuberculosis Report 2021. https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2021 Accessed 24 May 2023
Zimmermann, P., Tebruegge, M., Curtis, N., and Ritz, N. (2015). “The Management of Non-Tuberculous Cervicofacial Lymphadenitis in Children: A Systematic Review and Meta-Analysis.” Journal of Infection; 71(1): 9–18.
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