The application of atraumatic needle for puncture biopsy in tuberculosis of peripheral lymph nodes

Abstract

In extrapulmonary tuberculosis, especially tuberculosis of peripheral lymph nodes, the obtaining tissue for histological and bacteriological study presents certain difficulties. Currently, this problem is solved by obtaining of punctate or examination of excised lymphoid tissue. However, punctate examination is usually less informative, whereas lymph node excision is not widely available because of high traumaticity of method and subsequent formation of sufficiently coarse scars on open areas of the body. It is shown that the conduct of a standard biopsy in patients with suspected of tuberculous lymphadenitis allows you to verify the diagnosis by examining the punctate only in 75,9% of cases. The reasons for this is the impossibility of intake sufficient material for histological, bacteriological and molecular genetic studies, which are the most informative. Because of this, in the control group 24,1% of patients require repeat diagnostic operation – excision of lymph nodes tissue. The calculation of the 95% confidence interval showed that the percentage of patients in the general population who require this operation may range from 14,7 to 33,5% of all patients. The challenge of reducing the number of patients who need surgical intervention, was solved by the development of atraumatic needle (innovative patent number 67431). Calculation of overall sensitivity of atraumatic biopsy needle in the experimental group showed that its value in the case of atraumatic needle was 61,8%, which was 2,5 times higher than in the control group (p≤0,05). Using a specially designed needle instead of the traditional cut lymph node allows to achieve cure of patients with minimal residual skin changes.

Keywords

diagnosis of extrapulmonary tuberculosis / atraumatic needle / puncture lymph node / tuberculosis of peripheral lymph nodes / fine-needle biopsy / histological verification of tuberculosis / lymphatic system / mycobacterium tuberculosis / molecular genetic study of lymphoid tissue

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