Role of fine needle aspiration cytology of lymphnodes in the diagnosis of cutaneous tuberculosis.

ABSTRACT

Background: Lymph node involvement in cutaneous tuberculosis is primarily seen in patients with Scrofuloderma. However, patients with lupus vulgaris and TBVC sometimes present with regional lymphadenopathy. Demonstration of organism in skin biopsies by ZN stain and culture is time consuming and often unrewarding when bacillary load is considerably low. Fine needle aspiration cytology (FNAC) is an economical, dependable, quick and cost effective tool for an early diagnosis compared to biopsy studies. Aim: The present study was undertaken to assess the utility of FNAC of lymphnodes in diagnosis of cutaneous tuberculosis. Method: FNAC of affected lymph nodes in Scrofuloderma and lymph nodes draining the lesions in TBVC and lupus vulgaris was carried out followed by skin biopsy in 26 patients of clinically suspected cases of cutaneous tuberculosis. Observations Smears revealed epithelioid cell granulomas over a necrotic background. AFB could not be demonstrated by ZN stain. Histopathological studies of skin biopsies revealed epithelioid cell granulomas and Langhans’ giant cells. Biopsies were also negative for AFB by ZN stain and culture. All the patients responded well to standard antituberculous regimen. Conclusions: FNAC of lymph nodes in cases of cutaneous tuberculosis is a useful procedure that helps in arriving at diagnosis within a reasonable time frame.