Mycobacterium tuberculosis bacilli in oral biopsies containing granulomatous inflammation with caseous necrosis

Rubens Oliveira Signoretti-Silva; Ricardo Santiago Gomez; Marina Gonçalves Diniz; Silvana Spíndola de Miranda; Renato Santana Aguiar; Lida Jouca de Assis Figueredo; Marcelo Araújo Buzelin; Thaís Lima Araújo; Vanessa Bernardes

doi:10.5327/2525-5711.257

Authors

Rubens Oliveira Signoretti-Silva Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG) – Belo Horizonte (MG), Brazil. https://orcid.org/0000-0001-9524-8604
Ricardo Santiago Gomez Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG) – Belo Horizonte (MG), Brazil. https://orcid.org/0000-0001-8770-8009
Marina Gonçalves Diniz Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG) – Belo Horizonte (MG), Brazil. https://orcid.org/0000-0002-4212-1172
Silvana Spíndola de Miranda Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG) – Belo Horizonte (MG), Brazil. https://orcid.org/0000-0001-7245-4472
Renato Santana Aguiar Laboratory of Integrative Biology, Department of Genetics, Ecology and Evolution, Institute of Biological Sciences, Universidade Federal de Minas Gerais (UFMG) – Belo Horizonte (MG), Brazil. https://orcid.org/0000-0001-5180-3717
Lida Jouca de Assis Figueredo Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG) – Belo Horizonte (MG), Brazil. https://orcid.org/0000-0001-5355-0784
Marcelo Araújo Buzelin Laboratory Center Specialized in Histotechnology – Belo Horizonte (MG), Brazil. https://orcid.org/0000-0002-8442-8797
Thaís Lima Araújo Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG) – Belo Horizonte (MG), Brazil. https://orcid.org/0000-0003-3009-4311
Vanessa Bernardes Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG) – Belo Horizonte (MG), Brazil.

DOI:

https://doi.org/10.5327/2525-5711.257

Keywords:

Oral tuberculosis, Clinical laboratory techniques, Immunohistochemistry, Nested-PCR, Real-time polymerase chain reaction

Abstract

Objetive: This cross-sectional and retrospective study aimed to investigate the presence of Mycobacterium tuberculosis bacillus
in formalin-fixed paraffin-embedded (FFPE) oral samples that contained granulomas with caseous necrosis. Methods: FFPE
biopsies that showed granulomas with caseous necrosis, suggestive of the diagnosis of tuberculosis, were selected. M. tuberculosis
was searched by Ziehl-Neelsen staining (ZN), immunohistochemistry (IHC), nested-PCR, and GeneXpert® MTB/RIF assays.
Results: Nine samples showing granulomas with caseous necrosis were selected. The study showed a male predominance, with a ratio of 2.5:1, with a mean age of 50 (19-89) years, and the tongue was the most affected anatomical site (n=4). The ZN
technique did not detect bacilli in any sample, and IHC staining showed a coarse granular pattern staining, suggestive of M. tuberculosis, in three of them. Nested-PCR and the GeneXpert® MTB/RIF assays were positive in two and three of the samples, respectively. Conclusion: Molecular tests and IHC may be useful auxiliary methods for suspected cases of oral tuberculosis.

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Mycobacterium tuberculosis bacilli in oral biopsies containing granulomatous inflammation with caseous necrosis

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