title: The value of polymerase chain reaction detection of Mycobacterium tuberculosis in granulomas isolated by laser capture microdissection.
abstract: OBJECTIVE
  The aim of this study was to investigate the usefulness of polymerase chain reaction (PCR) detection of Mycobacterium tuberculosis in granulomas isolated by laser capture microdissection (LCM).
  
  
  METHODS
  The PCR DNA amplification method was used to detect M. tuberculosis in granulomas microdissected from one section stained by haematoxylin and eosin (H&E) from a formalin-fixed paraffin-embedded specimen. The results were compared to those obtained from PCR performed from 10 whole paraffin sections of 5 micro m each, and with the histology, culture and the patient's clinical findings.
  
  
  RESULTS
  Forty-nine formalin-fixed and paraffin-embedded samples from 49 patients with a histological suspicion of a mycobacterial infection were investigated. Using culture as the reference method, the sensitivity for the detection of M. tuberculosis was 92% and the specificity was 100% using PCR from microdissected granulomas and were similar to those obtained by using PCR from 10 whole sections.
  
  
  CONCLUSIONS
  The PCR method of examination of microdissected granulomas from deparaffinised sections is a sensitive, specific and rapid method for the detection of M. tuberculosis in formalin-fixed and paraffin-embedded samples. The method is as sensitive as that using PCR on 10 whole tissue sections, thus making it suitable for small biopsies. However, although these methods reduce the delay in diagnosis, culture remains the gold standard for identification of mycobacteria in tissue. Culture also allows for the testing of antibiotic sensitivity of any isolated species, in this way determining appropriate treatment.
authors.affiliation: INSERM 02-15 IFR 50, Nice, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Selva
authors.forename: Veronique
authors.initials: V
authors.lastname: Hofman
authors.forename: Frederick
authors.initials: F
authors.lastname: Berto
authors.forename: Sandra
authors.initials: S
authors.lastname: Musso
authors.forename: Laurent
authors.initials: L
authors.lastname: Castillo
authors.forename: Jose
authors.initials: J
authors.lastname: Santini
authors.forename: Pierre
authors.initials: P
authors.lastname: Dellamonica
authors.forename: Paul
authors.initials: P
authors.lastname: Hofman
mesh_terms: D000818:Animals; D005557:Formaldehyde; D006099:Granuloma / Q000382:microbiology*; D006801:Humans; D007834:Lasers; D042282:Microdissection; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D016612:Paraffin Embedding; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D016707:Tissue Fixation; D014376:Tuberculosis / Q000175:diagnosis*
chemical_list: D005557:Formaldehyde