Fine-needle Aspiration Cytology in Tuberculous Lymphadenitis: A Study of 200 Cases of Superficial Lymphadenopathy
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 5, Issue 10
Abstract
Background: In developing countries, tuberculous lymphadenitis is one of the most common causes of lymphadenopathy. Moreover, India is one of them. Patients are presenting with the only lymph node enlargement, with or without any symptoms. However, antitubercular treatment cannot be given only on clinical suspicion. Cytomorphology with acid-fast staining proves to be a valuable tool in diagnosing these cases. Aims: The aim is to study the advantages, limitations, and utility of fine-needle aspiration cytology (FNAC) and various cytomorphological presentations inreference to Ziehl-Neelsen (Z-N) staining in tuberculous lymphadenitis. Material and Methods: In a study period of January 2015–December 2016, in Pathology Department, GMERS Medical College, Ahmedabad, 200 cases in case of 300 patients with enlarged superficial lymph nodes, clinically suspected to be tuberculous were subjected to cytological evaluation with Hematoxylin and Eosin, Giemsa and Z-N stained smears. In addition, the social status and economic profile of these patients with the clinical presentation were also studied. Results: Incidence of tuberculous lymphadenitis was 63%. Overall acid-fast bacilli (AFB) positivity was 65.0%. Only necrosis without epithelioid cell granulomas was the most common cytological picture and that showed highest AFB positivity also. Threefourth of the patients presented in the second to fourth decades of life. Cervical region was the most common site of involvement with solitary lymphadenopathy as the most common presentation in contrast to matted lymph nodes as reported by others. Conclusions: FNAC is a safe, cheap procedure requiring minimal instrumentation and is highly sensitive to diagnose tuberculous lymphadenitis. The sensitivity can be further increased by complementing cytomorphology with acid-fast staining. In acid-fast staining negative cases, the yield of AFB positivity can be increased by doing Z-N staining on second smear or decolorized smear revealing necrosis or by repeat aspiration. Microbiological assessment should also be done in such cases.
Authors and Affiliations
Himani Patel, Kinara Patel, Jignasa Bhalodia
Keywords
Related Articles
- EP ID EP476023
- DOI -
- Views 108
- Downloads 0
A Study on Noise-induced Hearing Loss of Police Constables
Introduction: Noise is defined as aperiodic complex sound. Noise is a common cause of hearing the loss in adults. Hearing loss due to injurious noise at the workplace is referred to as occupational noise-induced hearing...
Surgical Management of Congenital Glaucoma - A Long-term Clinical Study and its Outcome
Introduction: Congenital glaucoma (CG) is more common, aggressive, and difficult to control. It results in raised intraocular pressure and diminished visual acuity in children. Many surgical procedures are described in t...
Parents’ Management of Acute Upper Respiratory Tract Infections in Children, Al Ahsa, Saudi Arabia
Introduction: Although upper respiratory tract infections (URTIs) are usually self-limiting and numerous off-the-counter medications used have no effect on outcome (2), self-medication is quite common in the pediatric po...
Prevention of Post-operative Nausea and Vomiting Following Laparoscopic Cholecystectomy
Background: Gallstone disease and its symptoms are frequently encountered in Indian population. Approximately, 80% of the gallstones are asymptomatic. Female sex, obesity, pregnancy, rapid weight loss, gallbladder stasis...
Role of Magnetic Resonance Venography, Diffusion-Weighted Imaging, and Gradient-Recalled Echo in Cerebral Sinovenous Thrombosis
Background: Cerebral venous thrombosis (CVT) is a cause of stroke with inconspicuous pathophysiological properties that differ from arterial stroke. It is an elusive diagnosis because of its non-specific presentation and...