Cytopathological Pattern of Tubercular Lymphadenopathy on FNAC: Analysis of 550 Consecutive Cases.
BACKGROUND
Fine needle aspiration cytology (FNAC) of lymph nodes is a simple, cost effective, out-patient procedure used for diagnosis of various causes of lymphadenopathies. In tuberculous lymphadenitis, it not only used for the cytological diagnosis but also used for other ancillary testing such as Ziehl- Neelsen staining and AFB Culture.


OBJECTIVE
Our study was designed to evaluate the cytopathological pattern of FNAC aspirate of patients presenting with lymphadenopathy with special reference to tuberculous lymphadenopathy.


METHODS
In this study all the patients referred to the cytopathology lab for FNAC of lymph nodes between January 2011 to June, 2013 were included. Out of 1050 patients presenting with lymphadenopathies, there were 550 cases of tuberculous lymphadenitis. The cytopathological findings of these 550 cases were analyzed.


RESULTS
A female preponderance was noted in our study with maximum incidence in the 3rd decade. Cervical lymph nodes were the most common nodes to be involved. Gross examination of aspirate showed maximum cases (74.5.2%) of whitish material. Among the four cytological patterns on FNAC, maximum cases demonstrated caseous necrotic material with degenerated inflammatory cells. Ziehl- Neelsen staining showed overall AFB positivity of 44.54%. Maximum AFB positivity was seen in cases having caseous necrosis only.


CONCLUSIONS
FNAC is a simple, cost effective technique with high degree of accuracy in diagnosing Tubercular Lymphadenitis. Despite certain limitations and pitfalls, FNAC coupled with Ziehl- Neelson staining should be the 1st line investigation in cases with lymphadenopaty, in a developing country with high prevalence rate of tuberculosis.
Senior Resident, Department of Pathology, Dr B.S. Ambedkar Hospital , New Delhi, India .
Priyanka
P
Chand
Senior Resident, Department of Pathology, Dr B.S. Ambedkar Hospital , New Delhi, India .
Rajeev
R
Dogra
Senior Resident, Department of Pathology, Dr B.S. Ambedkar Hospital , New Delhi, India .
Nidhi
N
Chauhan
Senior Specialist, Department of Pathology, Dr B.S. Ambedkar Hospital , New Delhi, India .
Renu
R
Gupta
Consultant & Head, Department of Pathology, Dr B.S. Ambedkar Hospital , New Delhi, India .
Pratima
P
Khare
Cytopathological pattern; FNAC; Tubercular lymphadenopathy; Ziehl- neelsen staining