Abstract :
Introduction: Fine needle aspiration cytology (FNAC) is widely accepted as the accurate, sensitive,
specific and cost-effective procedure in the diagnosis of lymphadenopathy. Tubercular lymphadenitis is
one of the most common causes of lymphadenopathy in developing countries like India.
Materials and Methods: An observational study was carried out at the pathology department of teaching
hospital in Delhi NCR from March 2013 to April 2017. A total of 3392 patients presented in the FNAC
OPD of the hospital, out of which 1730 had lymphadenopathies. Smears were stained with Giemsa and
categorised into the cytological pattern. Zheil Neelson (ZN) stain was done in all clinically suspicious
cases to tuberculosis. Data regarding brief history, site, age, sex, the gross appearance of aspirate and
cytomorphologic features were collected and analysed.
Results: Out of the 1730 cases of consecutive lymph node aspirations, 17 were excluded from the study
due to inadequate material, 979 cases (57.15%) showed features of Tubercular Lymphadenitis followed by
Reactive Lymphadenitis, 524 cases (30.58%). Out of the 20 cases which showed HIV positivity 18 showed
the presentation of tubercular lymphadenitis. TB was prevalent in all age groups, with the majority of cases
affecting people more than 50 years of age.
Conclusion: FNAC of lymphadenopathy is of particular importance in view of the high prevalence of
tuberculosis in our country, atypical presentation of tuberculosis and because AFB are seen mostly in
purulent aspirate smears which do not show granulomas, necrosis or epithelioid cells and which in the
absence of Ziehl-Neelsen staining can be dismissed as acute suppurative lymphadenitis. FNAC is a simple,
reliable, quick and economical diagnostic tool for peripheral lymph node lesions especially in the quick
and simple diagnosis of Tubercular Lymphadenitis.
Keyword :
Lymph node, Fine needle aspiration cytology FNAC, Tubercular lymphadenitis, Reactive lymphadenitis, Lymphoma.