Granulomatous lymphadenopathy and tuberculosis: accuracy of histology

IF 4.3 2区医学 Q1 INFECTIOUS DISEASES

International Journal of Infectious Diseases Pub Date : 2025-05-02 DOI:10.1016/j.ijid.2025.107920

Frédéric Méchaï , Lou Macaux , Florence Jeny , Yurdagül Uzunhan , Paul Cioni , Antoine Martin , Nicolas Vignier , Hilario Nunes

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引用次数: 0

Abstract

Objectives

Due to the insufficient sensitivity of microbiological tests, histology may be helpful for the diagnosis of tuberculosis (TB), especially extrapulmonary TB.

Methods

We used the database of the pathology laboratory from 2019 to 2023. We retrospectively analyzed the etiologies of lymph nodes finding epithelioid granuloma and their performance in diagnosing TB.

Results

We analyzed the files of epithelioid granulomas for 220 distinct patients. The main etiologies retained were sarcoidosis (n = 110; 50%), TB (n = 86; 39%), and bartonellosis (n = 4; 1.8%). The 74 granulomas with caseous necrosis were distributed between TB (n = 66; 89%), bartonellosis (n = 3; 4.1%), sarcoidosis (n = 2; 2.7%), histoplasmosis (n = 1; 1.4%), or remained undefined (n = 2; 2.7%). For the diagnosis of the 86 TB (55 certain and 31 probable), the caseous necrosis variable had a sensitivity, specificity, positive predictive value, and negative predictive value of 77%, 94%, 89%, and 86% respectively.

Conclusions

Histology confirms its accuracy for the diagnosis of TB and allows to quickly initiate a probabilistic treatment for suspected TB without microbiological documentation.

查看原文本刊更多论文

肉芽肿性淋巴结病与结核：组织学的准确性。

目的：由于微生物检查的敏感性不足，组织学可能有助于结核病的诊断，特别是肺外结核。方法：使用2019 - 2023年病理实验室数据库。我们回顾性分析淋巴结上皮样肉芽肿的病因及其在肺结核诊断中的作用。结果：我们分析了220例不同类型患者的上皮样肉芽肿档案。保留的主要病因为：结节病(n=110；50%)，肺结核(n=86；39%)和巴尔通体病(n=4；1.8%)。伴有干酪样坏死的肉芽肿74例，分布于结核之间(n=66；89%)，巴尔通体病(n=3；4.1%)，结节病(n=2；2.7%)，组织胞浆菌病(n=1；1.4%)，或仍未定义(n=2；2.7%)。对86例结核（确定55例，可能31例）的诊断，干酪样坏死变量的敏感性、特异性、阳性预测值和阴性预测值分别为77%、94%、89%和86%。结论：组织学证实了其诊断结核病的准确性，并允许在没有微生物记录的情况下快速启动疑似结核病的概率治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Infectious Diseases 医学-传染病学

CiteScore

18.90

自引率

2.40%

发文量

1020

审稿时长

30 days

期刊介绍： International Journal of Infectious Diseases (IJID) Publisher: International Society for Infectious Diseases Publication Frequency: Monthly Type: Peer-reviewed, Open Access Scope: Publishes original clinical and laboratory-based research. Reports clinical trials, reviews, and some case reports. Focuses on epidemiology, clinical diagnosis, treatment, and control of infectious diseases. Emphasizes diseases common in under-resourced countries.