PT  - JOURNAL ARTICLE
AU  - Kieran Zucker
AU  - Paul Whitaker
AU  - Hugh McGann
AU  - Timothy Collyns
AU  - John Watson
TI  - A retrospective analysis of lymph node sampling methods in patients with TB lymphadenitis
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P4475
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P4475.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P4475.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - Aims and Background:Only a limited body of literature exists on how best to investigate suspected Mycobacterium tuberculosis (TB) lymphadenopathy. We aimed to identify if any method of lymph node sampling had greater sensitivity in TB diagnosis.Methods:Records for all adult patients that were treated for extrapulmonary TB lymphadenitis between 2006 and 2010 were examined. The method of lymph node sampling, the rates of culture positivity, and the timescale of culture positivity were documented.Results:133 patients received treatment for extrapulmonary TB lymphadenitis. Blind fine needle aspiration (FNA) was performed in 61 (46%) of patients, ultrasound guided FNA in 17 (13%), TRUCUT biopsy in 10 (8%) and complete surgical excision in 15 (11%). Overall 39% of these patients were either microscopy or culture positive for TB.The sensitivities of the sampling methods were 61% for blind FNA, 32% for ultrasound guided FNA, 40% for TRUCUT biopsy and 33% for surgical excision. Chi square analysis revealed no significant difference between sampling methods. If a blind FNA sample were to become culture positive this happened by week 2 in 76% of patients and week 3 in 86%.Conclusions:Our data suggests that blind FNA yields results that are of equal diagnostic accuracy to alternative methods. The data suggests that week 3 post sampling might represent a suitable time to consider further sampling methods, as most will be positive by this time, if they are to become positive.