STUDY OF CYTOLOGICAL PATTERN IN TUBERCULAR LYMPHADENOPATHY AND ITS CORRELATION WITH ZIEHL-NEELSEN STAINING
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 7
Abstract
BACKGROUND Tubercular lymphadenopathy is the most common form of extrapulmonary tuberculosis accounting for 50% - 65% of cases. Though confirmative evidence of tubercular lymphadenopathy is AFB culture or excisional biopsy, fine needle aspiration cytology (FNAC) is a reliable tool as it is simple, rapid and cost-effective technique and its sensitivity can be further increased by ZiehlNeelsen staining. Hence, this study was done to assess various cytological patterns in tubercular lymphadenopathy and its correlation with Ziehl-Neelsen staining. The aim of this study is to study the various cytological patterns in tubercular lymphadenopathy and its correlation with ZiehlNeelsen staining. MATERIALS AND METHODS A retrospective, descriptive study was conducted in the Department of TB and Chest. Fifty two patients referred from various departments, whose FNAC patterns were suggestive of tubercular adenopathy and showed a clinical improvement after a full course of anti-tubercular treatment were included in the study. Their FNAC pattern and ZN staining were recorded. Information regarding age, gender, anatomical site, chest x-ray, Mantoux testing and comorbidities were noted. Follow-up of all patients throughout course of ATT and at completion was done and biopsy was advised for atypical cases, and those who failed to show clinical improvement after ATT. RESULTS Most common site of involvement was cervical 47 (90.4%) followed by axillary and inguinal. Out of 52 cases smears revealed epithelioid granuloma with caseation necrosis in 29 cases (55.8%), while 20 cases (38.5%) showed epithelioid granuloma without necrosis and 3 cases (5.8%) showed caseation necrosis without epithelioid granuloma. Out of 52 patients AFB positivity was seen in 22 patients (42.3%), of which maximum AFB positivity was seen in smears showing caseation necrosis alone without epithelioid granuloma (66.7%) followed by epithelioid granuloma with caseation necrosis (44.8%). Smears with epithelioid granuloma alone showed AFB positivity in (35%) cases. CONCLUSION Epithelioid granuloma with caseation necrosis was found to be the most common cytological pattern. Maximum AFB positivity was seen in cases where necrosis was the predominant microscopic pattern. Coupling FNAC with Ziehl-Neelsen staining increases the diagnostic accuracy in tubercular lymphadenopathy.
Authors and Affiliations
Bonny Pullolil James, Ancy Anthony Vithayathil
Keywords
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- EP ID EP399107
- DOI 10.14260/jemds/2018/194
- Views 97
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