Korean J Pathol.  1997 Aug;31(8):754-764.

Pathologic Diagnosis of Intestinal Tuberculosis in Endoscopic Biopsied Material

• Kim KM
• Lee AH
• Choi KY
• Oh SJ
• Shim SI

Abstract

The clinicopathologic features and the comparative analysis of diagnostic methods in 42 patients having intestinal tuberculosis were studied. In all the cases, clinical and colonoscopic diagnosis was confirmed by histological examination. Abdominal pain was the most common symptom (54%). Twenty nine patients had active pulmonary tuberculosis which was confirmed by a chest X-ray, or an AFB smear and a culture of sputum. A transverse ulcer with surrounding hypertrophic mucosa and multiple erosion was the usual colonoscopic findings. The granulomas were usually located in the just upper and lower portion of muscularis mucosa. The direct smear and culture of the fresh biopsy material showed AFB in 11 (32.4%) and 12 cases (36.4%) respectively. Ziehl-Neelsen staining in serially sectioned slides from formalin-fixed, paraffin- embedded tissue revealed AFB in 15 cases (35.7%). An immunohistochemical stain for Mycobacterium bovis was done in all cases and 13 cases were positive (31%). A polymerase chain reaction (PCR) was done and showed positivity in 4 out of 20 cases of fresh biospy material and 12 out of 40 cases in paraffin embedded tissue. For the conclusive diagnosis of intestinal tuberculosis, a Ziehl-Neelsen stain is the most sensitive, fast, and cost-effective method. The diagnostic accuracy will be increased when other diagnostic methods such as tissue culture and PCR are coupled with this simple staining method.

Keyword

Tuberculosis; Intestine; Diagnosis

MeSH Terms

Abdominal Pain
Biopsy
Diagnosis*
Granuloma
Humans
Intestines
Mucous Membrane
Mycobacterium bovis
Paraffin
Polymerase Chain Reaction
Sputum
Thorax
Tuberculosis*
Tuberculosis, Pulmonary
Ulcer
Paraffin