ABSTRACT
Background: Tuberculosis remains one of the major cause of morbidity and mortality in developing countries like India despite intense health campaigning and Government Programmes. Tuberculous lymphadenitis being the most common extra pulmonary manifestation of tuberculosis the incidence still on higher margin especially in resource poor areas which often goes unnoticed and remains as a diagnostic challenge to General Pathologists and sometimes even to Cytopathologists. Moreover the sequelae of COVID-19 pandemic had drastically impacted the management of TB, World Health Organisation had insisted to maintain continuity of essential services for people affected with TB during the COVID-19 outbreak worldwide. Aims & Objectives: To document the prevalence of tuberculous lymphadenitis among various patient groups and also to advocate the best method in early and prompt diagnosis of tuberculous lymphadenitis with an novel objective of proposing operational guidelines in the strategy of eradicating Tuberculosis. Materials & Methodology: In the prospective study conducted in SBV University Hospital, Puducherry a total number of 151 cases clinically suspected of tuberculous LN were included and patients with neoplastic lesion were excluded from this study. The lymph node aspirate collected were analysed for tuberculous cytomorphological changes by using routine cytological stains and observations were correlated with results of various ancillary diagnostic procedures. Results & Observations: Among 151 cases studied, 120 cases showed tuberculosis indicating high prevalence. 31 aspirates showed classical tuberculous pattern on cytomorphology, correlating well with histopathology (100%), Polymerase chain reaction (PCR) (100%) and culture (92%) respectively. In rest of the 119 cases carrying non tuberculous pattern on cytology, further exploration by ancillary diagnostic procedures revealed up tuberculosis in 79 cases with confirmation by culture, Histopathology and PCR. Conclusion: Our study showed prevalence of tuberculous lymphadenitis is on higher margin especially among low sociodemographic group and cytological procedure in adjunction with ancillary procedures proved to be reliable and helpful to Cytopathologists. PCR procedure could be widely employed by the Government especially in endemic regions with resource poor diagnostic facilities with scope for creating platform of multiplexing with additional resources so that PCR instruments can serve multipurpose testing tool.