The value of wide-needle aspiration in the diagnosis of tuberculous lymphadenitis in Africa.
AIDS
; 7(9): 1221-5, 1993 Sep.
Article
en En
| MEDLINE
| ID: mdl-8216979
ABSTRACT
OBJECTIVES:
To evaluate wide-needle (19-gauge) aspiration in the diagnosis of tuberculous lymphadenitis.SETTING:
Department of Surgery, University Teaching Hospital, Lusaka, Zambia. PATIENTS Three hundred and four patients presenting to one surgeon for diagnostic surgical biopsy of a peripheral lymph node during 1989-1990.DESIGN:
Prospective study in which wide-needle aspiration routinely preceded open surgical biopsy. MAIN OUTCOMEMEASURES:
Histology and mycobacterial culture of the surgically biopsied lymph node; HIV-1 serology; successful aspiration of material, naked-eye appearance of aspirate, presence of acid-fast bacilli and/or microscopic caseation in the aspirate.RESULTS:
One hundred and eighty-eight out of 304 (61.8%) patients had histologically and/or culture-proven tuberculous lymphadenitis, of whom 155 out of 183 (84.7%) tested HIV-1-seropositive. Material was successfully aspirated from 180 out of 188 (95.7%) of patients with proven tuberculous lymphadenitis. Macroscopic caseation, diagnosable on naked-eye examination alone of the aspirate, was present in 49 out of 120 (40.8%) consecutive aspirates from tuberculous nodes. Acid-fast bacilli and/or microscopic caseation were seen in 116 out of 155 (74.8%) aspirates from tuberculous nodes for which smears stained both by Ziehl-Nielsen and haematoxylin & eosin were available.CONCLUSIONS:
It is recommended that all patients with suspected tuberculous lymphadenitis in Africa, undergo wide-needle aspiration before surgical biopsy or empirical treatment.ABSTRACT
PIP This study evaluated wide-needle (19-gauge) aspiration in the diagnosis of tuberculous lymphadenitis. 304 patients presenting to 1 surgeon for diagnostic surgical biopsy of a peripheral lymph node during 1989 and 1990 at the Department of Surgery, University Teaching Hospital, Lusaka, Zambia, were involved in this prospective study in which wide-needle aspiration routinely preceded open surgical biopsy. Histology and mycobacterial culture of the surgically biopsied lymph node, HIV-1 serology, successful aspiration of material, naked-eye appearance of aspirate, and presence of acid-fast bacilli and/or microscopic caseation in the aspirate were the main outcome measures. 188 of 304 (61.8%) patients had histologically and/or culture-proven tuberculous lymphadenitis, of whom 155 of 183 (84.7%) tested HIV-1 seropositive. Material was successfully aspirated from 190 of 188 (95.7%) patients with proven tuberculous lymphadenitis. Macroscopic caseation, diagnosable on naked-eye examination alone of the aspirate, was present in 49 of 120 (40.8%) consecutive aspirates from tuberculous nodes. Acid-fast bacilli and/or microscopic caseation were seen in 116 of 155 (74.8%) aspirates from tuberculous nodes for which smears stained by both Ziehl-Nielsen and hematoxylin and eosin were available. It is recommended that all patients with suspected tuberculous lymphadenitis in Africa undergo wide-needle aspiration before surgical biopsy or empirical treatment.
Palabras clave
Africa; Africa South Of The Sahara; Biology; Developing Countries; Diseases; Eastern Africa; English Speaking Africa; Equipment And Supplies; Examinations And Diagnoses; Histology; Hiv Infections; Infections; Laboratory Examinations And Diagnoses; Prospective Studies; Research Methodology; Studies; Surgery; Surgical Equipment; Treatment; Tuberculosis; Viral Diseases; Zambia
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Banco de datos:
MEDLINE
Asunto principal:
Tuberculosis Ganglionar
/
Biopsia con Aguja
Tipo de estudio:
Diagnostic_studies
/
Evaluation_studies
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Observational_studies
/
Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Child
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Child, preschool
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Africa
Idioma:
En
Año:
1993
Tipo del documento:
Article