Utility of modified bleach method technique for the demonstration of acid fast bacilli in the diagnosis of Tuberculous lymphadenopathy in comparison to routine Ziehl-neelsen staining

Authors

  • Manika Khare PGIMER Dr Ram Manohar Lohia Hospital, New Delhi
  • Manju Kaushal PGIMER Dr Ram Manohar Lohia Hospital, New Delhi

Keywords:

Acid Fast Bacilli, Ziehl–Neelsen stain, Modified Bleach Method, Fine Needle Aspiration

Abstract

Background: There is major role of fine needle aspiration in diagnosis of tubercular lymphadenitis as it is a less invasive procedure and  Ziehl-Neelsen (ZN) method for acid-fast bacilli (AFB) plays a key role in diagnosis and also for  the monitoring of treatment in tuberculosis. The bleach concentration method is a technique with many benefits over routine ZN staining as it improves the sensitivity of direct microscopy for the detection of AFB.

Methods: A total of 129 cases of tuberculous lymphadenitis diagnosed by fine needle aspiration cytology (FNAC) were categorized into six cytomorphological patterns. The acid-fast bacilli positivity by routine staining was correlated with modified bleach methods of ZN staining. Sensitivity of routine ZN and modified bleach concentration was compared. Grading of acid fast bacilli and time taken to detect bacilli was also compared.

Result: The classic cytomorphological pattern of tuberculosis of epithelioid granulomas and caseous necrosis was seen in 21.1% of cases. Routine ZN staining detected AFB in 58.9% of cases and the modified bleach method in 89.1%. The modified bleach method showed AFB positivity in all cases where routine ZN staining was positive. The mean time taken for detection of AFB by modified bleach method was 8.91 minutes and by routine ZN staining method was 23.36 minutes.

Conclusion: The modified bleach method was more sensitive and safer than routine ZN staining. As the background was clear, the bacilli were easily visible and the screening time was shorter.

Author Biography

Manika Khare, PGIMER Dr Ram Manohar Lohia Hospital, New Delhi

DEPARTMENT OF PATHOLOGY, POST GRADUATE STUDENT

References

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Published

25-10-2016

How to Cite

1.
Khare M, Kaushal M. Utility of modified bleach method technique for the demonstration of acid fast bacilli in the diagnosis of Tuberculous lymphadenopathy in comparison to routine Ziehl-neelsen staining. Ann of Pathol and Lab Med [Internet]. 2016 Oct. 25 [cited 2025 Feb. 6];3(4):A329-332. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/apalm924

Issue

Vol. 3 No. 4 (2016)

Section

Original Article

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Copyright (c) 2016 Manika Khare, Manju Kaushal

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