ABSTRACT
Introduction: Tuberculous lymphadenitis is one of the common cause of Paediatric lymphadenopathy in India. This study was aimed to assess the usefulness of Fine needle aspiration cytology of lymph nodes as a diagnostic tool in suspected Tuberculosis and to observe the cyto morphological changes for better understanding of immune response. Material and methods: This was a cross sectional observational study conducted between the year 2016 to 2018 at Melmaruvathur tertiary care hospital. Children up to 14 years with suspected Tuberculosis symptoms and chronic lymphadenopathy irrespective of the sizes of nodes were subjected to Fine needle aspiration cytological study. Cyto smears morphology were observed and analysed. Results: A total of 81 cases were studied and the predominant age group affected were between five to ten years (n=46; 56.8%). 42 patients were female (51.9%) and 39 were male (48. 1%).Most of them had cervical nodes and 44% of nodes were less than 1 cm size. Out of 81 cases, 32 (39.5%) were diagnosed as nonspecific adenitis and 46 cases (56.8%) as granulomatous lymphadenitis. Among the size of the nodes, 57% of small nodes, 65% of medium sized nodes and 100% of large nodes showed granulomatous adenitis. Among sexes, female preponderance (63.1%) for granulomatous adenitis and male predominance (62.5%) for nonspecific adenitis were observed. Conclusion: Fine needle aspiration cytological study of paediatric lymphadenopathy is a useful diagnostic indicator in suspected Tuberculosis even for small size nodes and can be recommended if clinically warranted.
ABSTRACT
Background: Extra pulmonary tuberculosis (TB) is prevalent in developing countries and its diagnosis is often delayed, thus increasing the morbidity and mortality. Bleach method is cost effective, sensitive and safe method for demonstration of Acid fast bacilli (AFB) and is very valuable in diagnosing a case of tuberculous lymphadenitis. This simple procedure would benefit the patients to receive an early and specific treatment. Aims & Objective: The aim of our study was early diagnosis of tuberculosis in lymph node Fine needle aspiration cytology (FNAC) by bleach method for detection of AFB in comparison to conventional Ziehl–Neelsen (ZN) method. Material and Methods: Total 115 cases clinically suspected as tuberculous lymphadenitis in one year duration were included in study. All the aspirates by FNAC were processed for routine cytology, ZN staining and bleach method. The significance of the bleach method over the ZN method was analyzed using the χ2 (chi-square) test. Results: Among the 115 aspirates, 59.13% (68/115) were indicative of TB on cytology, 27.83% (32/115) were positive for AFB on conventional ZN method and the smear positivity increased to 61.74% (71/115) on bleach method. Conclusion: The implementation of the bleach method clearly improves microscopic detection of AFB over ZN method. The bleach method can be easily performed and reduce chances of laboratory acquired infections.