Journal of Histopathology and Cytopathology

Official Organ of Bangladesh Academy of Pathology

Vol 9, No 2, July 2025

Conventional Polymerase Chain Reaction in the Diagnosis of Extrapulmonary Tuberculosis from Formalin-Fixed, Paraffin-Embedded Tissues

 *Adhikary L,¹ Saha N,² Tabassom T,³ Jahan D,⁴ Hazari TJ,⁵   Jeba JT,⁶   Rahman MH⁷

 *Dr Lovely Adhikary, MD (Pathology), Assistant Professor of Pathology, Ad-din Sakina Women’s Medical College, Jashore, lovelymallick71@gmail.com

1. Dr Nirjhar Saha, MD (Pathology), Clinical pathologist, Mymensingh Medical College Hospital, Mymensingh
2. Dr Tasnova Tabassom, MD (Pathology), Lecturer, Netrokona Medical College, Netrakona
3. Dilshad Jahan, MD (Pathology), Assistant Professor of pathology, Barind Medical College, Rajshahi
4. Tasnim Jahan Hazari, MD (Pathology), Clinical Pathologist, Shaheed Tajuddin Ahmed Medical College Hospital, Gazipur
5. Jannatut Tahera Jeba, MBBS, Lecturer, Anatomy, Ad-din Sakina Women’s Medical College, Jashore
6. Md. Hasan Hafijur Rahman, DLO, Assistant Professor (ENT), Ad-din Sakina Women’s Medical College, Jashore

     *For correspondence

Abstract
Background: Tuberculosis is one of the serious public health problems of developing countries. There is also global rise in the incidence of tuberculosis as well as in Bangladesh. The extrapulmonary tuberculosis is also common. Poverty, malnutrition, low socioeconomic condition, overcrowding and immunodeficiency are the common causes of tuberculosis in Bangladesh. This research was conducted to see the usefulness of conventional PCR in the diagnosis of extrapulmonary tuberculosis from paraffin-embedded tissues.
Methods: This was a cross-sectional observational study where molecular detection of MTB DNA by targeting the gene IS6110 of MTB with the method of conventional PCR was done from paraffin embedded tissue samples. A total of 60 cases of extrapulmonary tuberculosis that were histologically diagnosed from tissue samples on the basis of granulomatous inflammation in the proper clinical context were included in the study. Paraffin block of each case was subjected to Ziehl-Neelsen staining followed by conventional PCR examination. Results of all the cases were collected and tabulated in a data sheet. Statistical analysis was performed on the tabulated data by Fisher’s exact test.
Results: Among 60 cases 37(61.66%) cases showed negative PCR examination whereas 23(38.33%) showed positive PCR examination. Among the PCR positive 23(38.33%) cases, 22(36.6%) cases histologically contained typical granuloma. In 1(1.7%) case granuloma was not found but caseous necrosis and Langhans’ giant cells were present and PCR examination was positive. Among the PCR positive 23(38.3%) cases, 22(36.6%) cases histologically contained typical caseous necrosis but in 1(1.7%) case caseous necrosis was not found but granuloma and Langhans’ giant cells were present and PCR examination was positive. In this study among 60 cases, Z-N stain was positive in 2 cases (3.3%) and negative in 58 cases (96.7%). Among the Z-N stain positive 2(3.3%) cases, PCR was positive in one case and in other case PCR examination was negative. Statistically significant association was not found with PCR examination results with granuloma (P-0.343) and caseous necrosis (p-0.675).
Conclusion: The results of the present study suggested that PCR can be considered as a diagnostic modality in the challenging cases of extrapulmonary tuberculosis from FFPE tissue samples by demonstrating the presence of MTB specific DNA.

[Journal of Histopathology and Cytopathology, 2025 Jul; 9 (2):78-88]
DOI: https://www.doi.org/10.69950/jhc2025v9i2s3

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