Cytomorphological Spectrum of Childhood Tuberculous Lymphadenitis
Journal Title: Indian Journal of Pathology: Research and Practice - Year 2018, Vol 7, Issue 2
Abstract
Introduction: Tuberculosis (TB) in children is a neglected aspect of the TB epidemic despite it constituting 20% or more of all TB cases in many countries with high TB incidence. Childhood TB is a direct consequence of adult TB but remains overshadowed by adult TB because it is usually smear-negative. Infants and young children are more likely to develop life-threatening forms of TB than older children and adults due to their immature immune systems. Therefore, prompt diagnoses are extremely important although difficult since clinical and radiological signs of TB can be non-specific and variable in children. In developing countries like India, tuberculous lymphadenitis is one of the most common causes of lymphadenopathy. However, anti-tubercular treatment cannot be given only on clinical suspicion. Cytomorphology with acid fast staining proves to be a valuable tool in diagnosing these cases. Aims: To study the utility of fine needle aspiration cytology (FNAC) and various cytomorphological presentations inreference to Ziehl-Neelsen staining in tuberculous lymphadenitis in paediatric age group. Methodology: Total 120patients attending OPD at Dr. Shankarrrao Chavan Government medical college, Nanded were studied for the period of two years. Result: Out of 120 aspirations from tuberculous lymph nodes, we found that only Necrosis without epithelioid cell granulomas was the most common cytological picture seen in 66 cases followed by necrotising granuloma in 25 cases. ZN-stained smears were positive in 76 cases while culture was positive in only 54 cases. The highest smear and culture positivity was noted in cases with only necrosis.overall AFB positivity was 66.3%. Conclusion: Fine needle aspiration cytology is a safe, cheap procedure requiring minimal instrumentation and is highlysensitive to diagnose tuberculous lymphadenitis. The sensitivity can be further increased by complementing cytomorphology with ZiehlNeelsen (ZN) staining for acid-fast Bacilli (AFB) and microbiological culture.
Authors and Affiliations
M. G. Panchal
Keywords
Related Articles
- EP ID EP514042
- DOI 10.21088/ijprp.2278.148X.7218.18
- Views 64
- Downloads 0
Significance of Masood’s Scoring Index in Cytological Diagnosis of Palpable Breast Lumps: A 3 Years Restrospective Studies
Introduction: Breast lump is the commonest presentation of breast diseases. Diagnosis of breast diseases can be made out based on history, physical examination and investigations, like cytology, histology and radiology....
Biotinidase Deficiency: Detection through Organicaciduria on TLC
Biotinidase is responsible for cleaving Biotin from Biocytin. Deficiency of biotinidase affects carboxylase enzymes causing dermatological, neurological, immunological or Ophthalmological complications. Biotinidase defic...
Mast Cell Count in Atopic and Contact Dermatitis
Context: Mast cells are the major effector cells in immediate hypersensitivity through activation via the high affinity IgE receptor and FcxRI. Given the broad array of proinflammatory mediators secreted from FcxRI – act...
Clinical and Histopathological Presentation of Papulosquamous Skin Disorders with Special Emphasis on Lichen Planus in Tertiary Care Hospital
Background: The papulosquamous disorders are complex to diagnose, because of the difficulty in identification and may resemble a similar disorder of the group. Lichen planus is an inflammatory dermal condition of the muc...
Seroprevalence of Transfusion Transmissible Infections among Blood Donors: A Retrospective Study
Context: Blood transfusion is a life saving measure in various medical and surgical emergencies. Transfusion medicine, apart from being important for the medical treatment of each patient, also has great public health im...