ABSTRACT
Background: Tuberculous lymphadenitis is the most common manifestation of extrapulmonary tuberculosis. Fine needle aspiration cytology (FNAC) is a valuable tool in diagnosis of tubercular lymphadenitis. The present study aims to determine the prevalence of different cytomorphological patterns in fine needle aspiration cytology of tubercular lymph nodes and their correlation with Acid Fast Bacilli (AFB) positivity on Ziehi-Neelsen (ZN) Staining.Methods: Fine needle aspiration cytology of 274 cases diagnosed as tubercular lymphadenitis over a period of a year were reviewed. Cytomorphological patterns were categorized into three patterns. Pattern I: Epithelioid granuloma without necrosis, Pattern II: Epithelioid granuloma with caseous necrosis and Pattern III: Caseous necrosis only. Fischer Exact test was applied to correlate cytomorphological pattern and AFB positivity.Results: Tuberculous lymphadenitis was most frequent in age group 21-30 years (24.81%). Cervical lymph nodes were the most frequent lymph nodes involved (84.67%). Pattern I was the most common cytomorphological pattern observed (49.3%). Overall AFB positivity was 28.10%. Maximum AFB positivity was seen in pattern III (73.3%).Conclusions: FNAC is the simple, cost effective and minimally invasive tool to diagnose tuberculous lymphadenitis. Study of both cytomorphological pattern and ZN staining for AFB can improve the diagnostic accuracy.
ABSTRACT
Background: Fine Needle Aspiration Cytology (FNAC) is simple, quick, inexpensive and minimally invasive OPD technique used to diagnose different types of swellings located in the neck. Aims & Objective: (1) To assess the distribution of various cytomorphological patterns of cervical lymphadenopathy; (2) To assess the age specific distribution of various cytomorphological patterns of cervical lymphadenopathy. Materials and Methods: This study was carried out at GMERS Medical College and Hospital, Valsad, on 196 clinically diagnosed cases of cervical lymphadenopathy over a period of two years from January 2010 to December 2011.FNAC was carried out in all these patients. Fine Needle Aspiration Diagnosis was correlated with details of relevant clinical findings and investigation. Results: Total 196 cases were studied, out of these 173 (88.26%) were found inflammatory and 23 (11.73%) were neoplastic. Tuberculosis was the most common disease found in 109 (55.61%) patient followed by chronic nonspecific lymphadenitis 49 (25.00%), Metastatic tumours 21 (10.71%), acute lymphadenitis 15 (7.65%), Lymphoma 2 (1.02%). Highest incidence of cervical lymphadenopathy was found inpatients of 11 to 30 years age group. Conclusion: Fine Needle Aspiration Cytology is easy, simple, safe, reliable and non-invasive procedure for diagnosis of cervical lymphadenopathy and easy way for surgeon to decide whether to go for surgery or not.