Fine needle aspiration cytodiagnosis of clinically suspected tuberculosis in tissue enlargements.
A retrospective study of the use of fine needle aspiration (FNA) cytology to confirm a clinical suspicion of tuberculosis in tissue enlargements was performed, using 70 cases. The criteria required to make an FNA cytodiagnosis of tuberculosis were reassessed, and the sensitivity and predictive value of cytology for diagnosing such aspirates was determined. All but 2 of the 70 aspirates contained adequate cellularity. The adequate samples were diagnosed as 40 cases of caseating tuberculosis, 11 cases of noncaseating tuberculosis and 17 cases of acute necrotizing granulomatous inflammation suspicious for tuberculosis. Subsequent histologic study verified the cytologic diagnosis in 27 of 27 biopsied caseating lesions, 4 of 7 biopsied noncaseating cases and 5 of 8 necrotizing cases. The six cases with a false-positive cytodiagnosis of tuberculosis were histologically diagnosed as one Lennert's lymphoma, two reactive lymph nodes and three necrotizing metastatic carcinomas. The sensitivity of FNA cytology for the diagnosis of tuberculosis was 100%, with the predictive value of a positive result being 88%. The findings in this study emphasize that all criteria for the diagnosis of tuberculosis in FNA samples must be utilized and that particular caution should be exercised in making a diagnosis of acute necrotizing tuberculosis.
Shariff
S
S
Department of Pathology, St. John's Medical College, Bangalore, Karnataka, India.
Thomas
J A
JA
D001707:Biopsy, Needle / Q000379:methods; D003581:Cytodiagnosis / Q000379:methods; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D006099:Granuloma / Q000473:pathology; D006801:Humans; D007249:Inflammation; D007962:Leukocytes / Q000473:pathology; D014376:Tuberculosis / Q000175:diagnosis / Q000473:pathology*