Diagnosis of nontuberculous mycobacterial lymphadenitis: the role of fine-needle aspiration
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ORIGINAL ARTICLE
Diagnosis of nontuberculous mycobacterial lymphadenitis: the role of fine-needle aspiration Raquel Olivas-Mazón 1 & Daniel Blázquez-Gamero 1,2,3 M. Dolores Delgado-Muñoz 6 & Cristina Epalza 1,2,3
&
Nuria Alberti-Masgrau 4 & Paula López-Roa 5 &
Received: 12 May 2020 / Revised: 2 November 2020 / Accepted: 11 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Nontuberculous mycobacterial lymphadenitis often presents a diagnostic challenge. This study aimed to evaluate the role of fineneedle aspiration cytology in the diagnosis of nontuberculous mycobacterial lymphadenitis in children. We conducted a retrospective review of fine-needle aspiration cytology performed in patients < 17 year-old with subacute lymphadenitis from 2003 to 2016 in a tertiary hospital in Spain. Confirmed nontuberculous mycobacterial lymphadenitis (isolation of nontuberculous mycobacterial in culture from fine-needle aspiration cytology or biopsy samples) and probable nontuberculous mycobacterial lymphadenitis (“granulomatous inflammation” in cytopathologic examinations from fine-needle aspiration cytology or biopsy and clinical-epidemiological history compatible with nontuberculous mycobacterial) were selected. Forty-one patients with nontuberculous mycobacterial lymphadenitis were included: 14 confirmed and 27 probable. Fine-needle aspiration cytology was done in all of them. For 34 patients with excised lymphadenopathy, cytopathology from fine-needle aspiration cytology was concordant with biopsy in 100% cases. Culture results were available from 78.0% (32/41) of patients with fine-needle aspiration cytology and from 85.3% (29/34) with excisional biopsy. Among 22 patients with microbiological results from fine-needle aspiration cytology and biopsy, fine-needle aspiration cytology allowed advanced results in concordance with biopsy or with positive isolation not found in biopsy in 90.1% (20/22) of patients. Sensitivity of nontuberculous mycobacterial cultures obtained by fine-needle aspiration cytology compared to biopsy was 45.5% vs. 36.4% (p = 0.07). Two patients with previous skin alterations presented fistulas after fine-needle aspiration cytology (4.9%); no other complications were described. Conclusion: Fine-needle aspiration cytology provides quick cytopathologic information and is an accurate and safe technique for the diagnosis of nontuberculous mycobacterial lymphadenitis, especially in cases with challenging work-up.
Communicated by Nicole Ritz * Daniel Blázquez-Gamero [email protected] Raquel Olivas-Mazón [email protected]
1
Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Avenida de Córdoba S/N, 28048 Madrid, Spain
2
Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
3
Red de Investigación Traslacional en Infectología Pediátrica (RITIP), Madrid, Spain
4
Department of Pathology, Hospital Universitario 12 de Octubre, Madrid, Spain
5
Department of
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