title: Fine needle aspiration biopsy of the spleen in pyrexia of unknown origin.
abstract: To evaluate the diagnostic utility, value and potential risk of fine needle aspiration biopsy of spleen (sFNAB) in patients with splenomegaly in pyrexia of unknown origin (PUO), a retrospective analysis of medical records and cytological material of 31 patients on whom FNAB was performed between April 1994 and October 1997 was done. The patients were HIV- and presented with PUO. All other relevant investigations were negative. The spleen was either palpable or detected to have space-occupying lesions on ultrasonography (USG). The splenic aspirates showed tuberculosis in 11 patients (35.4%) and inconclusive or reactive changes in nine patients (25.8%). One case out of this group proved to be Kaposi's sarcoma on autopsy. The other diseases encountered were leishmaniasis (n = 3), non-Hodgkin's lymphoma (n = 4), fungal infections (n = 2), Hodgkin's lymphoma (n = 1). The patients who were diagnosed as having tuberculosis had epithelioid cells, giant cells, necrosis and inflammatory cells in various combinations. AFB positivity was 63.6%. The other cases which showed granulomas but no AFB were diagnosed on empirical grounds and all responded to the anti-tuberculosis therapy. No complications were encountered with the procedure. Therefore the authors conclude that sFNAB is rewarding in patients where all other non-invasive modalities of diagnosis have failed.
authors.affiliation: Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: A
authors.initials: A
authors.lastname: Rajwanshi
authors.forename: D
authors.initials: D
authors.lastname: Gupta
authors.forename: S
authors.initials: S
authors.lastname: Kapoor
authors.forename: R
authors.initials: R
authors.lastname: Kochhar
authors.forename: S
authors.initials: S
authors.lastname: Gupta
authors.forename: S
authors.initials: S
authors.lastname: Varma
authors.forename: S
authors.initials: S
authors.lastname: Gupta
mesh_terms: D000328:Adult; D000368:Aged; D001230:Aspergillus / Q000302:isolation & purification; D001707:Biopsy, Needle; D015622:Epithelioid Cells / Q000473:pathology; D005260:Female; D005335:Fever of Unknown Origin / Q000150:complications / Q000175:diagnosis*; D006099:Granuloma / Q000473:pathology; D006658:Histoplasma / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D012189:Retrospective Studies; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology*; D013163:Splenomegaly / Q000209:etiology / Q000473:pathology*; D014400:Tuberculosis, Splenic / Q000175:diagnosis / Q000382:microbiology; D014463:Ultrasonography