Diagnosis of Tuberculous Cervical Lymphadenitis using Nested Polymerase Chain Reaction

ABSTRACT

Tuberculous cervical lymphadenitis(TCL) has some problems in microbiologic, pathologic, immunologic diagnostic procedures. More accurate diagnostic means has been needed beacuse TCL requires long-term antituberculous chamotherapy as long as 18 months. Recently, polymerase chain reaction (PCR) which amplifies known DNA segments was applied to the diagnosis of tuberculosis. However, the sensitivity of PCR is low with the samples of low-microorganism-burden. Nested PCR (nPCR) was introduced as a good alternative increasing the sensitivity of PCR by repeated amplification of DNA segment with inner primers which exist in the DNA sequence of first PCR products. Fifteen cases which were suspected to TCL were undertaken fine needle aspiration (FNA) and/or excisonal biopsy from enlarged cervical lymph nodes. All samples were examined with pathologic studies, simple PCR using INS-1/INS-2 primers, and nPCR using outer SCL-1/SCL-2 primers and inner SCL-3/SCL-4 primers. Eeight in fifteen patients were pathologically diagnosed to tuberculosis. Aspiration cytology diagnosed 2 cases to tuberculosis and did not confirm but suspect tuberculosis in 3 cases of thier 12 cases. A case of cases compatible with tuberculosis was diagnosed to subacute necrotizing lymphadenitis with tissue...