Fine needle aspiration cytology in the diagnosis of superficial lymphadenopathy in children and adolescents: an analysis of 869 cases

Fine needle aspiration cytology [FNAC] in children has gained acceptance gradually and is currently used extensively as an initial diagnostic tool. This study was undertaken to determine the value of FANC in peripheral lymphadenopathy in pediatric and adolescent patients in Kuwait. Retrospective. Mubarak Al-Kabeer Hospital, Kuwait. Eight hundred and sixty-nine children and adolescents [ranging from five months to 20 years] from January 2000 to September 2009. FNAC. The spectrum of disease of lymph nodes in pediatric and adolescent age groups, using FNAC. Out of the 4116 lymph node aspirates performed, the cytology reports of 869 [21.1%] pediatric aspirates were reviewed. There were 409 [51.3%] male and 388 [48.7%] female patients. Seventy-two [8.3%] were considered unsatisfactory. Out of the 797 [91.7%] satisfactory aspirates, reactive lymphoid tissue was reported in 616 cases [77.3%], lymphadenitis in 115 [14.4%], atypical cytology in 18 [2.3%], lymphoreticular malignancy in 46 [5.7%] and metastatic tumor in 2 [0.3%]. The lymphadenitis included 8, 66, 23 and 18 cases of necrosis only, granulomatous lymphadenitis, necrotizing granulomatous lymphadenitis and tuberculous lymphadenitis [where acid fast bacilli were detected respectively. FNAC of lymph nodes in children and adolescents is feasible and reliable. Majority of the nodes revealed reactive lymphoid tissue and helped allay the fears of parents thereby preventing unnecessary surgery

Correlation of fine needle aspiration cytological features of extra-pulmonary tuberculous lesions with detection of acid fast bacilli-Mubarak Al Kabeer hospital, Kuwait experience

To correlate the spectrum of cytomorphological changes in fine needle aspirates [FNA]of extrapulmonary tuberculous lesions with the demonstration of acid fast bacilli [AFB] by Ziehl-Neelsen [ZN] staining and culture of the mycobacterial organism Prospective, from January 2008 to August 2009 Mubarak Al Kabeer Hospital, Kuwait Three hundred and eighty-one patients with suspected tuberculosis FNA was done on lymph nodes [313 cases, 82%], soft tissue [37 cases, 10%], breast [24 cases, 6%], thyroid [3 cases, 1%] and epididymis [4 cases, 1%]. Papanicolaou and / or May-Grunwald-Giemsa [MGG] stained smears were classifiedinto:Group A: granulomas with necrosis [n=202,53%], Group B: granulomas alone [n=59, 15.5%], Group C: acellular necrosis alone [n=53, 13.9%] and Group D: acute inflammatory exudate [n=67,17.6%]. The cytomorphological features of extra-pulmonary tuberculosis in FNA were correlated with AFB demonstration by ZN staining and mycobacterial culture. The AFB positivity by ZN stain was 46.6, 7.9, 58.1 and 22% in groups A, B, C and D respectively. Culture was positive in 53.1, 6.7, 56 and 15.4% in groups A, B, C and D respectively. In 32 out of 109 cases both ZN staining and culture were positive. In 77 cases negative for AFB the culture was positive in 31.2% and negative in 68.8%. Evaluation of all FNA from suspected cases of tuberculosis should include staining for AFB and culture for mycobacteria