JOURNAL COVER PAGE
 
 
 
 
VOLUME 8,ISSUE 2
April - June 2019
 
Abstract

Comparative Study of Bleach Method and Zeihl Nelson Staining in Lymph Node FNAC in Suspected Tuberculosis Lesions: A Two Year Prospective Study

Vijay C. Popat1, Neeru Dave2, Nidhi Pagia3, Neha Jadhav4

1Prof & Head; Department of Pathology, Shri M. P. Shah, Government Medical College, Jamnagar.
2Associate Prof; Department of Pathology, Shri M. P. Shah, Government Medical College, Jamnagar.
3Consultant Pathologist; Department of Pathology, Shri M. P. Shah, Government Medical College, Jamnagar.
4Resident. Department of Pathology, Shri M. P. Shah, Government Medical College, Jamnagar.

ABSTRACT

BACKGROUND AND OBJECTIVES: Ziehl–Nelson (ZN) method for acid-fast bacilli (AFB) plays a key role in the diagnosis and monitoring of treatment in tuberculosis. Its major disadvantage is low sensitivity. Mycobacterial culture is the reference method, but it is time consuming and requires specialized safety procedures in laboratories. Serological techniques have the disadvantage of lack of sensitivity and specificity. Newer molecular techniques, such as polymerase chain reaction, are costly to be routinely used in developing countries where tuberculosis is prevalent. Microscopy has many advantages when it comes to speed and feasibility, and if its sensitivity could be improved, it has the potential to be a more valuable tool for tuberculosis control programs around the world. Thus the need for new, improved, low-cost technique. To evaluate improved sensitivity of bleach concentration method over conventional ZN stained smears on fine needle aspirates of lymph nodes in the diagnosis of tubercular lymphadenitis METHODS: 198 clinically suspected cases of tuberculosis with enlarged peripheral lymph nodes were subjected to FNAC. Smears were prepared and stained by ZN stain by conventional method as well as by treating with modified bleach method and evaluated for acid fast bacilli. RESULTS: The modified bleach method treatment of fine needle aspirates before ZN staining was able to detect more AFB as compared to conventional direct ZN stain. It detected an additional 62/150 cases which were negative on direct ZN smears and increased the smear positivity by 41.33%. CONCLUSION: This study suggests that the bleach method can significantly improve the diagnostic yield for tuberculous lymphadenitis and thus help in early n effective treatment.

Keywords: Tuberculous lymphadenitis, acid fast bacilli, ZeihlNelson stain, modified bleach method.


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