Can cytomorphology of granulomas distinguish sarcoidosis from tuberculosis? Retrospective study of endobronchial ultrasound guided transbronchial needle aspirate of 49 granulomatous lymph nodes.
BACKGROUND
The differential diagnosis of tuberculosis (TB) and sarcoidosis on fine needle aspiration material is very challenging in tubercular endemic regions. We carried out a pilot study to explore cytomorphologic features of granulomas which could help in differentiation between sarcoidosis and TB. Final diagnoses in these patients were based on clinical, microbiologic and follow-up studies.


METHODS
Endobronchial ultrasound guided transbronchial needle aspiration smears of 49 consecutive patients with a final cytologic diagnosis of granulomatous lymphadenitis were reviewed. Based on cytologic features two cytologic categories were enunciated and the results were correlated with microbiologic studies and/follow-up of minimum of 6 months.


RESULTS
The cytologic categories did not correlate with the final clinical outcome of patients.


CONCLUSIONS
Different patterns of granulomas observed in cytology smears do not help distinguish TB from sarcoidosis. The novel non-invasive techniques of mediastinal sampling though help in confirming granulomatous pathology, distinction between these entities and treatment decisions still depend upon correlating cytologic, microbiologic, clinical and radiological data in a large number of cases in tubercular endemic regions.
Address: Department of Cytopathology, Sir Gangaram Hospital, New Delhi, India.
Gagandeep
G
Kaur
Amit
A
Dhamija
Jolsana
J
Augustine
Pooja
P
Bakshi
Kusum
K
Verma
Endobronchial ultrasound guided transbronchial needle aspiration; granulomas; sarcoidosis; tuberculosis