title: Eosinophilic Structure: Should it be Included in Routine Cytology Reporting of Tuberculosis Lymphadenitis?
abstract: BACKGROUND
  Fine needle aspiration cytology is a simple, rapid procedure routinely employed for the diagnosis of tuberculosis lymphadenitis. Positivity for acid fast bacilli (AFB) in Ziehl-Neilsen stained smear is still considered as gold standard for diagnosis of Tuberculosis, but all lesions may not yield AFB, thus pose diagnostic problems. Few cytomorphological changes i.e. Eosinophilic structure (ES) in the stained smears correlates with the presence of AFB thus, helping us in rapid diagnosis.
  
  
  OBJECTIVE
  To evaluate the correlation between AFB and ES in necrotic lymph node aspirates.
  
  
  METHODS
  This is a retrospective study conducted from January to December 2014. Lymphnodes upon purulent aspiration which were reported as granulomatous lymphadenitis suggestive of tuberculosis were included in the study. All the stained smears (H&E, MGG and ZN Stains) for each case were retrieved from the files and rescreened for the presence of ES, granulomas and AFB. Presences of ES were correlated with AFB.
  
  
  METHODS
  Stastistical analysis was done using Chi-square test.
  
  
  RESULTS
  Our study included 103 cases. The common age group involved was 21-40 years, with female predominance. Cervical lymph nodes were most commonly involved. In relation to ES and AFB, four different cytological pictures were seen i.e., ES and AFB-(31%); ES-AFB+(16.5%); ES+, AFB+(39%); ES+AFB-(14.5%). Chi-square test showed a highly significant stastistical association between ES and AFB with p=0.001.
  
  
  CONCLUSIONS
  Eosinophilic structure is one of the cytomorphological features to be considered in necrotic lymph node aspirate which has a significant correlation with AFB in the smears. Hence pathologist should search for this, and it should be included in routine cytology reporting of tuberculosis lymphadenitis.
authors.affiliation: Assistant Professor, Department of Pathology, Employees' State Insurance Corporation Medical College and PGIMSR , Rajajinagar, Bangalore, Karnataka, India .
authors.forename: Panduranga
authors.initials: P
authors.lastname: Chikkannaiah
authors.affiliation: Post Graduate Student, Department of Pathology, Employees' State Insurance Corporation Medical College and PGIMSR , Rajajinagar, Bangalore, Karnataka, India .
authors.forename: Mythri M
authors.initials: MM
authors.lastname: Boovalli
authors.affiliation: Professor and Head, Department of Pathology, Employees' State Insurance Corporation Medical College and PGIMSR , Rajajinagar, Bangalore, Karnataka, India .
authors.forename: Srinivasa Murthy
authors.initials: SM
authors.lastname: Venkataramappa
keywords: Acid Fast Bacilli; Cytology; FNAC
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