Role of fine needle aspiration cytology for the diagnosis of tuberculosis and frequency of its presentation as cold abscess in lower Sindh

ABSTRACT

This study was carried out to evaluate the role of Fine Needle Aspiration Cytology [FNAC] for the diagnosis of Tuberculosis and to estimate the frequency of its presentation as cold abscess in lower Sindh. A total number of 73 patients were included in this study. These patients were all referred to a private clinic for FNAC of swellings in lymphoid regions, chest wall, Abdomen, breast and lower back. Duration of study was six months from January to June 2013. Fine needle aspiration was done and smears were made for cytopathological diagnosis. All patients were clinically followed up to see the response to treatment. Age range was 2 to 70 years. Mean age being 29 years. Lesions were more common in females [72.60%].Out of 73 patients majority n=26 [35.26%] presented with cervical lymphadenopathy, n=11 [15.06%] presented with a supraclavicular mass, n=10 [13.70%] had submandibular swelling and n=06 [8.21%] had axillary lymphadenopathy. Other sites included preauricular / retro parotid areas, chest wall swelling and breast, each accounting for 4 [5.48%] cases. Less common sites were Lumbar area on back, posterior auricular area and swelling on thumb, n=1 each [1.36%]. Cytopathological analysis showed n=30 [41.10%] diagnosed as Tuberculous lymphadenitis while n=23 [31.51%] were labeled as cold abscess, n=17 [23.29%] were reported tuberculosis with extensive Caseation necrosis and n=3 [4.10%] were reported as Tuberculous Mastitis. All patients were put on ATT with clinical follow up. Fine needle aspiration is a very useful, cost effective method for early and rapid diagnosis of tuberculosis and cold abscesses. This obviates the need for incisional / excisional biopsy and patients can directly be put on ATT with strict clinical follow up