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Abstract：
BACKGROUND: The diagnosis of intestinal tuberculosis is challenging even nowadays. This study aims to report the positivity rates of new diagnostic methods such as immunohistochemistry and Real-Time Polymerase Chain Reaction in patients with intestinal tuberculosis, as well as describe the pathological and endoscopic features of intestinal tuberculosis in our population.
METHODS: This was a retrospective observational study conducted in patients diagnosed with intestinal tuberculosis, between 2010 to 2023 from the Hospital Nacional Daniel Alcides Carrion and a Private Pathology Center, both located in Peru. Clinical data was obtained, histologic features were independently re-evaluated by three pathologists; and immunohistochemistry and real-time Polymerase Chain Reaction evaluation were performed. The 33 patients with intestinal tuberculosis who fulfilled the inclusion criteria were recruited.
RESULTS: Immunohistochemistry was positive in 90.9% of cases, while real-time Polymerase Chain Reaction was positive in 38.7%. The ileocecal region was the most affected area (33.3%), and the most frequent endoscopic appearance was an ulcer (63.6%). Most of the granulomas were composed solely of epithelioid histiocytes (75.8%). Crypt architectural disarray was the second most frequent histologic finding (78.8%) after granulomas, but most of them were mild.
CONCLUSIONS: Since immunohistochemistry does not require an intact cell wall, it demonstrates higher sensitivity compared to Ziehl-Neelsen staining. Therefore, it could be helpful for the diagnosis of paucibacillary tuberculosis.
METHODS: This was a retrospective observational study conducted in patients diagnosed with intestinal tuberculosis, between 2010 to 2023 from the Hospital Nacional Daniel Alcides Carrion and a Private Pathology Center, both located in Peru. Clinical data was obtained, histologic features were independently re-evaluated by three pathologists; and immunohistochemistry and real-time Polymerase Chain Reaction evaluation were performed. The 33 patients with intestinal tuberculosis who fulfilled the inclusion criteria were recruited.
RESULTS: Immunohistochemistry was positive in 90.9% of cases, while real-time Polymerase Chain Reaction was positive in 38.7%. The ileocecal region was the most affected area (33.3%), and the most frequent endoscopic appearance was an ulcer (63.6%). Most of the granulomas were composed solely of epithelioid histiocytes (75.8%). Crypt architectural disarray was the second most frequent histologic finding (78.8%) after granulomas, but most of them were mild.
CONCLUSIONS: Since immunohistochemistry does not require an intact cell wall, it demonstrates higher sensitivity compared to Ziehl-Neelsen staining. Therefore, it could be helpful for the diagnosis of paucibacillary tuberculosis.
摘要：
背景：如今，肠结核的诊断仍具有挑战性。本研究旨在报告新的诊断方法，如免疫组织化学和实时聚合酶链反应在肠结核患者中的阳性率。以及描述我们人群肠结核的病理和内镜特征。
方法：这是一项对诊断为肠结核的患者进行的回顾性观察研究，2010年至2023年之间，来自国家医院DanielAlcides腐肉和私人病理中心，都位于秘鲁。获得临床数据，由3名病理学家独立重新评估组织学特征,并进行免疫组织化学和实时聚合酶链反应评估.纳入33例符合纳入标准的肠结核患者。
结果：在90.9%的病例中免疫组织化学阳性，而实时聚合酶链反应阳性率为38.7%。回盲区是受影响最大的区域(33.3%),最常见的内镜外观是溃疡（63.6%）。大多数肉芽肿仅由上皮样组织细胞组成（75.8％）。隐窝结构紊乱是继肉芽肿之后第二常见的组织学发现（78.8%），但大多数都很温和。
结论：由于免疫组织化学不需要完整的细胞壁，其显示与Ziehl-Neelsen染色相比更高的灵敏度。因此,这可能有助于诊断少杆菌结核。
方法：这是一项对诊断为肠结核的患者进行的回顾性观察研究，2010年至2023年之间，来自国家医院DanielAlcides腐肉和私人病理中心，都位于秘鲁。获得临床数据，由3名病理学家独立重新评估组织学特征,并进行免疫组织化学和实时聚合酶链反应评估.纳入33例符合纳入标准的肠结核患者。
结果：在90.9%的病例中免疫组织化学阳性，而实时聚合酶链反应阳性率为38.7%。回盲区是受影响最大的区域(33.3%),最常见的内镜外观是溃疡（63.6%）。大多数肉芽肿仅由上皮样组织细胞组成（75.8％）。隐窝结构紊乱是继肉芽肿之后第二常见的组织学发现（78.8%），但大多数都很温和。
结论：由于免疫组织化学不需要完整的细胞壁，其显示与Ziehl-Neelsen染色相比更高的灵敏度。因此,这可能有助于诊断少杆菌结核。
