RESUMO
BACKGROUND: Tuberculous lymphadenitis is most common cause of lymphadenopathy in developing countries. Although enormous literature is available on various aspects of the disease including cytological patterns and its incidence in others parts of India and in other countries, only limited literature is available regarding its incidence and morphological spectrum on cytology in eastern parts of Uttar Pradesh in Gorakhpur region. AIM: The present study was undertaken to estimate the incidence of tuberculous lymphadenitis in our settings along with its morphological spectrum on cytology as well as to determine the utility of culture of fine needle aspirates in addition to cytology and Ziehl-Neelsen (ZN) staining. MATERIAL AND METHODS: Four hundred cases of superficial lymphadenopathy were subjected to fine needle aspiration cytology (FNAC), and in case, smears were stained with Hematoxylin and eosin (H and E), Giemsa, and ZN stain and categorized into three cytomorphological patterns. All the aspirates were inoculated on two sterile Lowenstein Jensen (LJ) medium. RESULT: Out of 400 cases of consecutive lymph nodes aspirated, 180 cases (45%) showed features of tuberculous lymphadenitis. Smears revealed epithelioid granulomas with caseous necrosis in maximum cases (40%). On statistical analysis, difference between group I and group II was found to be significant (P < 0.05); while comparison between groups II and III as well as between groups I and III was found to be statistically insignificant. Overall, acid fast bacilli positivity was seen in 51.6% of the cases. CONCLUSION: FNAC has been proved very safe, highly sensitive, and first line investigation in diagnosing tubercular lymphadenitis. The sensitivity can be further be increased by complementary cytomorphology with acid fast staining. Diagnostic accuracy can further be increased by culture.
RESUMO
BACKGROUND: Filariasis is a major health problem in tropical countries including India. Fine needle aspiration cytology plays an important role in prompt recognition of disease. AIM: To assess the role of fine needle aspiration cytology (FNAC) in diagnosis of filariasis at all possible sites. MATERIALS AND METHODS: Total 250 cases of superficial swellings at various sites were subjected to fine needle aspiration cytology. RESULTS: Out of 250 cases, 24 cases of filariasis were detected which include breast lumps (8 cases), lymph nodes (6 cases), scrotal swellings (4 cases), thyroid swellings (3 cases), soft tissue swellings (2 cases) and ascitic fluid (1 case). Eosinophilia was present in 8 out of 24 cases with a percentage ranging from 12-24%. Significant adherence of inflammatory cells and macrophages to microfilariae was present in 3 out of 24 cases. CONCLUSIONS: In endemic areas, it should be considered one of the differential diagnoses of a superficial swelling. Careful screening of FNAC smears help in detecting microfilaria even in asymptomatic patients and thus plays a significant role in recognition of the disease and institution of specific treatment.
