Immunocytochemical Expression of IFN-γ and IL-4 in Tuberculous Lymphadenitis with Dark Oval Bodies


  • Humairah Medina Liza Lubis Postgraduate, Doctoral Programme, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
  • Ratna Akbari Ganie Departement of Clinical Pathology, Faculty of Medicine, Universitas Sumatera Utara, General Hospital of H. Adam Malik, Medan, Indonesia
  • Delyuzar Delyuzar Departement of Anatomical Pathology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
  • Putri Chairani Eyanoer Departement of Community Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
  • Delfitri Munir Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia



Dark oval bodies, Interferon-γ, Interleukin-4


BACKGROUND: We noticed some smears being cytologically diagnosed as common chronic lymphadenitis that cannot be treated with ordinary antibiotics, but succeeded with the anti-tuberculosis drug (ATD), even though it takes longer, up to a year or more. Re-examining the MGG smears, we got cases that show the structure, we call Dark Oval Bodies (DOB). Most of DOB smears express Interferon (IFN)-γ. IFN-γ _plays a role in the protection of infection while interleukin (IL)-4 in the opposite.

AIM: The purpose of this study is to determine if there is a difference between an expression of IFN-γ _and IL-4 in DOB and whether IFN-γ _is associated with the protection of the disease.

MATERIALS AND METHODS: Included in this study 41 cases of tuberculous lymphadenopathy with DOB that were not successfully treated with common antibiotics but succeeded with ATD. Antigen expression was determined using rabbit polyclonal to IFN-γ, (ab9657), and IL-4 (ab9622), Abcam. The expression was categorized as positive and negative. The details of the 41 cases were 37 cases (90%) with IFN-γ _(+), 4 (10%) with IFN-γ _(-), 10 (24%) with IL-4 (+), and 31 (76%) with IL-4 (-). Thirty cases expressed IFN-γ _(+) and IL-4 (-), 1: IFN-γ _(-) and IL-4 (+), 8: IFN-γ _(+) and IL-4 (+), and 2: IFN-γ _(-) and IL-4 (-).

RESULTS: IFN-γ _is more frequently expressed in DOB compared to IL-4 (p<0.05, the Fisher’s exact tests).

CONCLUSION: IFN-γ _can be benefited as the indicator of protection to the tuberculous process.


Download data is not yet available.


Metrics Loading ...

Plum Analytics Artifact Widget Block


World Health Organization. Global Tuberculosis Report. Geneva: World Health Organization; 2018.

Mustafa T, Stanley J, Sayoki GM. Immunohistochemical analysis of cytokines and apoptosis in tuberculous lymphadenitis. Immunology. 2006;117(4):454-62. PMid:16556259

Mohapatra PR, Janmeja AK. Tuberculous lymphadenitis. J Assoc Physicians India. 2009;57(8):585-90. PMid:20209720

Tadele A, Beyene D, Hussein J, Gemechu T, Birhanu A, Mustafa T, et al. Immunocytochemical detection of Mycobacterium tuberculosis complex specific antigen, MPT64, improves diagnosis of tuberculous lymphadenitis and tuberculous pleuritis. BMC Infect Dis. 2014;14:585. PMid:25421972

Gupta V, Bhake A. Clinical and cytological features in diagnosis of peripheral tubercular lymphadenitis a hospital-based study from central India. Indian J Tuberc. 2017;64(4):309-13. PMid:28941854

Kaufmann SH. Protection against tuberculosis: Cytokines, T cells, and macrophages. Ann Rheum Dis. 2002;61(Suppl 2):ii54-8. PMid:12379623

Flynn JL, Chan J, Lin PL. Macrophages and control of granulomatous inflammation in tuberculosis. Mucosal Immunol. 2011;4(3):271-8. PMid:21430653

Romero-Adrian TB, Leal-Montiel J, Fernández G, Valecillo A. Role of cytokines and other factors involved in the Mycobacterium tuberculosis infection. World J Immunol. 2015;5(1):15-60.

Ridha S, Fatah K, Juffrie M, Setyati A. Differences in interferon gamma in childhood tuberculosis. Sari Pediatr. 2017; 18(5):385- 90.

Al-Attiyah R, Madi NM, El-Shamy AM, Wiker HG, Andersen P, Mustafa AS. Cytokine profiles in tuberculosis patients and healthy subjects in response to complex and single antigens of Mycobacterium tuberculosis. FEMS Immunol Med Microbiol. 2006;47(2):254-61. PMid:16831212

Kak G, Raza M, Tiwari BK. Interferon-gamma (IFN-γ): Exploring its implications in infectious diseases. Biomol Concepts. 2018;9(1):64-79. PMid:29856726

Koo GC, Gan Y. The innate interferon gamma response of BALB/c and C57BL/6 mice to in vitro Burkholderia pseudomallei infection. BMC Immunol. 2006;7:19. PMid:16919160

Lubis HM. Badan-badan Kecil Berbentuk Oval Gelap di dalam Kelompokan Makrofag dan Bercak-bercak Gelap: Dua Struktur Terabaikan dalam Diagnosis Limfadenitis Tuberkulosis. Tesis. Available from: [Last accessed on 2020 Nov 11].

Naslednikova IO, Urazova OI, Voronkova OV, Strelis AK, Novitsky VV, Nikulina EL, et al. Allelic polymorphism of cytokine genes during pulmonary tuberculosis. Bull Exp Biol Med. 2009;148(2):175-80. PMid:20027321

Ma M, Xie L, Wu S, Tang F, Li H, Zhang Z, et al. Toll-like receptors, tumor necrosis factor-α, and interleukin-10 gene polymorphisms in risk of pulmonary tuberculosis and disease severity. Hum Immunol. 2010;71(10):1005-10. PMid:20650298

Surewicz K, Aung H, Kanost RA, Jones L, Hejal R, Toossi Z. The differential interaction of p38 MAP kinase and tumor necrosis factor-α _in human alveolar macrophages and monocytes induced by Mycobacterium tuberculois. Cell Immunol. 2004;228(1):34- 41. PMid:15203318

Wu S, Wang Y, Zhang M, Wang M, He JQ. Genetic variants in IFNG and IFNGR1 and tuberculosis susceptibility. Cytokine. 2019;123:154775. PMid:31310896

Dünne AA, Kim-Berger HS, Zimmermann S, Moll R, Lippert BM. Atypical Mycobacterial tuberculosis a diagnostic and therapeutic dilemma? Case reports and review of the literature. Otolaryngol Pol. 2003;57(1):17-23. PMid:12741139




How to Cite

Lubis HML, Ganie RA, Delyuzar D, Eyanoer PC, Munir D. Immunocytochemical Expression of IFN-γ and IL-4 in Tuberculous Lymphadenitis with Dark Oval Bodies. Open Access Maced J Med Sci [Internet]. 2020 Oct. 28 [cited 2024 Apr. 21];8(A):806-9. Available from:

Most read articles by the same author(s)

1 2 3 > >> 

Similar Articles

You may also start an advanced similarity search for this article.