Abstract :
Background: Tuberculous lymphadenitis is the most common cause of lymphadenopathy in India. Despite,
availability of many literature on Daignosis and management of Tuberculosis in various parts of India,
practically diagnosis of Tuberculosis sometimes pose a challenge to the pathologists and clinicians. A
holistic diagnostic approach of cytology with aid of special stain and histopathological evaluation resolves
this diagnostic dilemma.
Aim: The present study was carried out to evaluate the different cytological patterns of tuberculous
lymphadenitis in our settings along with utility of special stain like Acid fast stain and further
histopathological evaluation
Material and Methods: Five hundred and three cases of superficial lymphadenopathy were subjected
to Fine Needle Aspiration Cytology (FNAC), and smears were prepared and stained with Hematoxylin
and eosin (H and E), Giemsa, Papanicalou and Acid Fast stain and were categorized into three
cytomorphological patterns. If the swelling underwent excision biopsy, they were correlated with
histopathological examination also.
Result: Out of 503 cases of lymph node swelling aspirated, 200 cases (39.7%), showed features of
Tuberculous lymphadenitis. Majority of cases (72.2%) were in their second to fourth decades of life, with
male-to-female ratio of 1:2. Cervical region was the most common site of involvement. Smears revealed
epithelioid granulomas with caseous necrosis in maximum cases (55%).AFB positivity was seen highest in
smears revealing necrosis only with or without epithelioid cell granulomas (76.3%).
Conclusion: FNAC has been proved very safe, highly sensitive, and first line investigation in diagnosing
tubercular lymphadenitis. Hence, the approach to tubercular lymphadenitis attains completeness with
cytopathological and histopathological evaluation.
Keyword :
Cytological patterns, Tubercular lymphadenitis, Acid fast smear.