Abstract :
Background: Tubercular lymphadenopathy is the most common manifestation of extra pulmonary tuberculosis. Fine needle aspiration cytology (FNAC) is a safe, inexpensive method to diagnose tuberculosis which if coupled with Ziehl Neelson (Z.N) staining can give accurate results.
Aim and Objective: To categorize the cytomorphological patterns of tubercular lymphadenitis and estimate the Acid-fast bacilli (AFB)positivity in each pattern along with comparison of AFB positivity among all the four patterns.
Material and Methods: Total 292 patients, diagnosed of features, such as granulomatous lymphadenitis, chronic necrotising granulomatous lymphadenitis, chronic necrotising abscess and chronic necrotising lymphadenitis on cytology, suggestive of tubercular origin, were categorised as four distinct cytomorphological patterns respectively. All the cases were also simultaneously subjected for Z.N staining. Percentage of AFB positive cases in each pattern was calculated.
Results: Highest AFB positivity was observed in cases of chronic necrotising lymphadenitis (95.4%), followed by chronic necrotising granulomatous lymphadenitis (82.6%), chronic necrotising suppurative lymphadenitis (53.5%) and least in granulomatous lymphadenitis (1%). Overall AFB positivity was 53.4%.
Conclusion: Tubercular lymphadenopathy presents with distinctive patterns on cytology and is also variably positive for AFB staining depending on the immune status of the patient.
Keyword :
Cytomorphological patterns, FNAC, Tubercular lymphadenitis, Acid-fast bacilli.