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Bennani K, Khattabi A, Akrim M, Mahtar M, Benmanssour N, Essakalli L, Karkouri M, Cherradi N, El Messaoudi D, Lahlou O, Cherkaoui I, Khader Y, Maaroufi A, Ottmani SE
Evaluation of the Yield of Histopathology in the Diagnosis of Lymph Node Tuberculosis in Morocco, 2017: Cross-Sectional Study
Evaluation of the yield of histopathology in the diagnosis of lymph node
tuberculosis in Morocco, 2017
Kenza Bennani;
Asmae Khattabi;
Mohamed Akrim;
Mohamed Mahtar;
Najib Benmanssour;
Leila Essakalli;
Mehdi Karkouri;
Nadia Cherradi;
Driss El Messaoudi;
Ouafae Lahlou;
Imad Cherkaoui;
Yousef Khader;
Abderrahmane Maaroufi;
Salah Eddine Ottmani
ABSTRACT
Background:
Extrapulmonary tuberculosis (EPTB) frequency has been increasing worldwide over the last two decades. In Morocco, EPTB cases accounts for 46% of the patients reported with new episode of TB. Lymph node TB (LNTB) is the most common form of EPTB. In line with the guidelines of the National TB Programme, the diagnosis is mainly based on clinical evidence, including histopathology.
Objective:
This study aimed to evaluate the yield of histopathology testing in the diagnosis of LNTB.
Methods:
This cross-sectional prospective study was conducted among patients with cervical lymph node who were enrolled in the study from November 2016 to May 2017 in three regions of Morocco. The outcomes of histopathological testing were compared to those of bacteriology. Sensitivity (Se), specificity (Sp), Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of histopathology testing were calculated. Culture and Xpert testing wa used as a gold standard.
Results:
A total of 262 patients were enrolled in this study. The Se, Sp, PPV and NPV of histopathology testing were 95.6%, 64.6%, 74.1% and 93.2% respectively in presence of granuloma with or without caseous necrosis and 84.4%, 74.8%, 78.1% and 81.9% respectively in presence of granuloma with caseous necrosis. The granuloma with caseous necrosis was associated with increased PPV and Sp of histopathology testing (p<0.05).
Conclusions:
The presence of the granuloma with caseous necrosis in histopathological examination had significantly improved the yield of histopathology for the diagnosis of LNTB The findings suggests to maintain histopathology testing in establishing the LNTB diagnosis and to explore other techniques to improve it.
Citation
Please cite as:
Bennani K, Khattabi A, Akrim M, Mahtar M, Benmanssour N, Essakalli L, Karkouri M, Cherradi N, El Messaoudi D, Lahlou O, Cherkaoui I, Khader Y, Maaroufi A, Ottmani SE
Evaluation of the Yield of Histopathology in the Diagnosis of Lymph Node Tuberculosis in Morocco, 2017: Cross-Sectional Study