Role of Fine Needle Aspiration Cytology And Histopathology in Diagnosis of Cervical Lymph Node Tuberculosis
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 2
Abstract
Background: Tuberculosis (TB) has been remained a major global health problem from ancient times. Diagnosis of TB on the basis of histopathology is an important issue since long in anatomical pathology. Extra pulmonary TB is predominantly associated with cervical lymph nodes presented by swollen glands usually at base and or sides of the neck. Taking limitations of serology, Ziehl Neelsen smear and culture techniques into the account morphological analysis based on histology seems to be the most achievable method for diagnosis of TB. Objective: To see the value of Fine Needle Aspiration Cytology, Fine Needle Biopsy and or histopathology in diagnosis Cervical Lymph Node TB and to compare it with Acid Fast Bcilli smear and culture on Lowenstein Jensen medium. Study Design &Settings: This descriptive study was undertaken in Department of Pathology, King Edward Medical University, Lahore, in collaboration with all allied departments during January 2015 to December 2015. Methods: After taking informed consent, patients were prepared for fine needle procedure under aseptic conditions. A senior pathologist took the specimen and then each specimen was divided into two parts. Hematoxylin and eosin staining was used to observe the morphological changes in the cells. Petroff’s method of concentration and decontamination was used to process samples for ZN smear and culture. Results: A total of 78 patients of age 15 years and above comprising of 21 males and 57 females with male to female ratio of 1:2.71 were included in present study. Mean age of the patients remained 26.55±14.09. Out of total 78 patients 8(10.25%) provided surgically removed lymph node specimens, 6(7.69%) provided small biopsies and 64 (82.05%) were performed fine needle aspirate (FNA) for cytology. Sensitivity of AFB smear, culture and Histopathology/cytology findings remained 16.7%, 89.7% and 93.6% respectively. Conclusion:Histopathology/cytology is the only tool presenting timely morphological changes suggestive of Cervical Lymph Node TB and can be used to start anti tubercular treatment. Culture on Lowenstein Jensen medium, Ziehl Neelsen smear and response to anti tubercular treatment must not be ignored on the other hand and should be followed for proper management of disease.
Authors and Affiliations
Muniba Rahman, Sajjad Ali Shahid, Shahzad Ahmad, Muhammad Imran Sarwar, Muhammad Kashif Munir, Sana Rehman, Iqra Riaz
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