title: Tularemia in differential diagnosis of cervical lymphadenopathy: cytologic features of tularemia lymphadenitis.
abstract: OBJECTIVE
  Tularemia can cause cervical lymphadenopathy. Fine-needle aspiration (FNA) cytology is the first step in the workup for cervical lymphadenopathy; however, little has been published regarding the cytomorphological features of tularemia lymphadenitis. The aim of this study was to evaluate the FNA cytology of tularemia lymphadenitis.
  
  
  METHODS
  Review of medical records identified 36 patients with serologically proven tularemia, and who had undergone lymph node FNA. In each case, the original May-Grünwald-Giemsa-stained FNA smears from enlarged cervical lymph node were reevaluated.
  
  
  RESULTS
  Suppuration and cytolysis were frequent cytological findings. Twenty-three (63.8%) of the 36 cases were assessed as suppurative inflammation. In 10 of these cases (27.8% of the total), cytolysis was prominent. In 7 cases (19.4%) the smears featured microgranulomas as well as suppuration, and 2 of these (5.6%) also featured giant cells. In 1 case (2.8%), there was caseous necrosis. In 2 cases (5.6%), the cytopathological findings were consistent with reactive lymphoid hyperplasia. Three aspirates (8.3%) were inadequate for evaluation.
  
  
  CONCLUSIONS
  Cytopathological findings on FNA of tularemia lymphadenitis are nonspecific; however, in regions where tularemia is endemic, this disease should be considered in the differential diagnosis for suppurative lymphadenitis.
authors.affiliation: Department of Pathology, Medical Faculty of Gaziosmanpasa University, Tokat, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Markoc
authors.forename: Resid Dogan
authors.initials: RD
authors.lastname: Koseoglu
authors.forename: Sema
authors.initials: S
authors.lastname: Koc
authors.forename: Levent
authors.initials: L
authors.lastname: Gurbuzler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008199:Lymphadenitis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D014406:Tularemia / Q000175:diagnosis*; D055815:Young Adult