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

ABSTRACT

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 classifiedintoGroup 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