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AFB- detection of DNA by Real time PCR Tissue and biopsy

Biopsy
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Report in 72Hrs

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No Fasting Required

Details

PCR test for Mycobacterium tuberculosis DNA in biopsy samples.

₹3,552₹5,074

30% OFF

AFB - Detection of DNA by Real Time PCR Tissue and Biopsy

  • Why is it done?
    • Detects Mycobacterium tuberculosis DNA in tissue and biopsy specimens using Real Time PCR (qPCR) technology for rapid and sensitive diagnosis of tuberculosis
    • Diagnose active tuberculosis infection, particularly extrapulmonary TB (lymph nodes, organs, tissues, bones, central nervous system)
    • Provide definitive diagnosis when histopathology shows caseating granulomas but AFB smear microscopy is negative or inconclusive
    • Evaluate immunocompromised patients (HIV/AIDS) with suspected disseminated tuberculosis
    • Differentiate tuberculosis from other granulomatous diseases (sarcoidosis, fungal infections, malignancy)
    • Deliver faster results compared to traditional culture methods which can take 2-8 weeks
    • Guide initiation of anti-tuberculous therapy in suspected cases, especially in critical conditions
  • Normal Range
    • Normal/Negative Result: No Mycobacterium tuberculosis DNA detected (Ct value >40 or undetectable) indicates absence of TB infection in the tissue sample
    • Units of Measurement: Cycle Threshold (Ct) value or Quantification Cycle (Cq) value; qualitative reporting as Positive or Negative; quantitative results reported as copies/mL when applicable
    • Interpretation Categories: Negative (Ct >40 or no amplification); Positive (Ct <40, typically <35); Borderline/Indeterminate (Ct 35-40 may require repeat testing)
    • What Normal Means: Negative results suggest no active TB infection in the sampled tissue; however, does not exclude TB if clinical suspicion remains high
    • What Abnormal Means: Positive result indicates presence of Mycobacterium tuberculosis DNA, confirming TB infection; requires clinical correlation with symptoms, imaging, and histopathology
  • Interpretation
    • Positive Result (Ct <40): Indicates active Mycobacterium tuberculosis infection; patient likely has TB and requires initiation of anti-tuberculous therapy; lower Ct values suggest higher bacterial load
    • Negative Result (Ct >40): No TB DNA detected; TB infection unlikely in this tissue sample; consider alternative diagnoses if clinical presentation suggests TB; repeat testing may be warranted with fresh specimens
    • Borderline/Indeterminate (Ct 35-40): Results near the cutoff threshold; should be interpreted cautiously; repeat testing, improved sample quality, or clinical reassessment recommended
    • Factors Affecting Interpretation: Sample quality and quantity; timing of specimen collection; patient immune status; prior TB treatment; contamination during collection or processing; presence of PCR inhibitors
    • Sensitivity and Specificity: Real Time PCR typically shows 85-95% sensitivity and 90-99% specificity for TB detection in tissue; variations depend on tissue type and bacterial load; better performance in lymph node and abscess specimens compared to other tissues
    • Clinical Correlation Essential: Results must be interpreted with clinical symptoms, radiological findings, tuberculin skin test (TST) or interferon-gamma release assay (IGRA), histopathology, and AFB microscopy results
  • Associated Organs
    • Primary Organ Systems Involved: Respiratory system (lungs); lymphatic system (lymph nodes); central nervous system (meninges); musculoskeletal system (bones, vertebrae); gastrointestinal tract; genito-urinary system; other organs in disseminated TB
    • Diseases Diagnosed or Monitored: Pulmonary tuberculosis; tuberculosis lymphadenitis; tuberculous meningitis; skeletal TB (Pott's disease); abdominal TB; cutaneous TB; urogenital TB; miliary (disseminated) TB
    • Common Associated Conditions: HIV/AIDS with opportunistic TB infection; caseating granulomas on histology; constitutional symptoms (fever, night sweats, weight loss); chronic inflammation; lymphadenopathy
    • Potential Complications of Abnormal Results: If TB confirmed: organ-specific damage (lung cavitation, neurological impairment in TB meningitis, spinal cord compression in Pott's disease); systemic dissemination; multi-drug resistant TB (MDR-TB); treatment-related side effects
    • Differential Diagnoses to Consider: Sarcoidosis; fungal infections (histoplasmosis, coccidioidomycosis); atypical mycobacterial infections (MAC, NTM); malignancy; other granulomatous diseases
  • Follow-up Tests
    • If Result is Positive: Mycobacterial culture for species confirmation and drug susceptibility testing (DST); rifampicin and isoniazid resistance detection; fluoroquinolone resistance testing; Line Probe Assay (LPA) for rapid DST; drug-resistant TB panel if MDR-TB suspected
    • If Result is Negative but Clinical Suspicion High: Repeat tissue biopsy or PCR testing; culture on Löwenstein-Jensen (LJ) or MGIT media; AFB smear microscopy; chest imaging (X-ray, CT); tuberculin skin test (TST) or interferon-gamma release assay (IGRA); serology if available
    • Additional Diagnostic Tests: GeneXpert MTB/RIF for rapid TB and rifampicin resistance detection; NAAT (Nucleic Acid Amplification Tests); immunohistochemistry (IHC) staining; next-generation sequencing (NGS) for comprehensive mycobacterial characterization
    • Complementary Tests: Immunological tests (CD4 count, HIV testing); liver and kidney function tests (baseline before anti-TB therapy); baseline audiometry (for aminoglycoside monitoring); retinopathy screening (for ethambutol)
    • Monitoring During Treatment: Sputum AFB microscopy and culture (monthly); chest imaging (at completion of therapy); clinical assessment at 2, 4, and 8 weeks; repeat tissue biopsies if treatment failure suspected
    • Post-Treatment Follow-up: Imaging studies to assess resolution; clinical examination at regular intervals; TST or IGRA (may remain positive indefinitely post-treatment); sputum AFB microscopy at end of therapy; screening for TB recurrence
  • Fasting Required?
    • Fasting Required: NO - Fasting is not required for this test as it involves tissue or biopsy specimen analysis, not blood sampling
    • Sample Collection Requirements: Fresh tissue or biopsy specimen obtained through surgical or needle biopsy; minimum 50-100 mg tissue recommended; immediate fixation in appropriate preservative (10% neutral buffered formalin or sterile saline depending on laboratory protocol)
    • Pre-Procedure Instructions: Consent for biopsy procedure; inform about procedure risks and benefits; patient may eat and drink normally unless biopsy is under general anesthesia (follow anesthesia fasting guidelines); continue regular medications unless instructed otherwise
    • Medications: Continue regular medications; anticoagulants (warfarin, aspirin, DOAC) may need adjustment if invasive biopsy planned; notify physician of current antibiotic therapy as it may affect PCR results if specimens were taken during active treatment
    • Special Specimen Handling: Sterile collection containers; avoid contamination with non-sterile material; rapid transport to laboratory (preferably within 2-4 hours); proper labeling with patient identification and collection time; temperature control if specified by laboratory
    • Post-Procedure Care: Rest as advised; monitor biopsy site for infection or bleeding; follow wound care instructions; report any excessive pain, fever, or drainage; normal dietary intake immediately after procedure unless otherwise specified

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