Fine needle aspiration of lymphadenopathy in visceral leishmaniasis.
OBJECTIVE
To illustrate the cytomorphologic features of Leishmania lymphadenitis associated with visceral leishmaniasis (V/L) and post-kala-azar dermal leishmaniasis (PKDL) and to highlight the fact that Leishmania lymphadenitis must he included in the differential diagnosis of patients presenting with lymphadenopathy, particularly in areas endemic for the disease.


METHODS
Fine needle aspiration (FNA) was routinely done in 21 cases of lymphadenopathy in VL (18 cases) and PKDL (3 cases), and the detailed cytomorphologic features were correlated with the respective histopathologic findings.


RESULTS
Amastigote forms of Leishman-Donovan (LD) bodies were seen in 19 cases both intracellularly, in histiocytes and multinucleate giant cells, and extracellularly. The FNA smears revealed a polymorphous population of cells composed of lymphocytes, histiocytes, plasma cells, giant cells and tingible body macrophages. In a few cases, epithelioid cell granulomas were also seen. The cytomorphologic features were confirmed and correlated on histopathology.


CONCLUSIONS
Not all lymphadenopathy in VL and PKDL is due to Leishmania lymphadenitis. Demonstration of LD bodies on FNA smears helps with the early diagnosis of VL and PKDL with lymphadenopathy where the diseases are endemic.
Sah
Shatrughan Prasad
SP
Department of Pathology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal. sah_sp@yahoo.com
Prasad
Rajniti
R
Raj
Gita Ashok
GA
D000293:Adolescent; D000328:Adult; D044963:Biopsy, Fine-Needle; D002648:Child; D005260:Female; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000473:pathology; D007898:Leishmaniasis, Visceral / Q000473:pathology*; D008196:Lymph / Q000166:cytology / Q000469:parasitology; D008198:Lymph Nodes / Q000473:pathology*; D008199:Lymphadenitis / Q000469:parasitology* / Q000473:pathology*; D008297:Male