title: Tuberculous lymphadenitis: Comparison of cytomorphology, Ziehl-Neelsen staining, and rapid mycobacterial culture at a pediatric superspecialty hospital.
abstract: BACKGROUND
  To evaluate and compare the role of Ziehl-Neelsen (ZN) staining and mycobacterial culture in diagnosis of tuberculous lymphadenitis.
  
  
  METHODS
  A total of 56 fine needle aspirations (FNAs) from patients who were clinically suspected to have tuberculous lymphadenitis were included. Acid-fast Bacilli detection was attempted by ZN staining on smears as well as culture on Middlebrook 7H9 broth. Percentage positivity of both smears and culture was calculated.
  
  
  RESULTS
  Of the 56 cases, 46 showed cytomorphological features consistent with tuberculosis (TB). The most common pattern was only necrosis in 37 cases followed by necrotizing granulomas in 13 cases. ZN-stained smears were positive in 40 cases while culture was positive in only 27 cases. The highest smear and culture positivity was noted in cases with only necrosis. In six cases, diagnosis of TB was made on culture alone since smear was negative in these cases.
  
  
  CONCLUSIONS
  FNA is a reliable technique for early and accurate diagnosis of tuberculous lymphadenitis in many cases. Mycobacterial culture by newer rapid techniques can assist in bacillary detection in smear-negative cases and also allows for drug sensitivity testing. Hence, culture should be resorted to in such cases.
authors: Address: Department of Pathology, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
authors: Sonam
authors: S
authors: Mahana
authors: Address: Department of Pathology, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
authors: Reena
authors: R
authors: Tomar
authors: Address: Department of Pathology, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
authors: Rawi
authors: R
authors: Agrawal
authors: Department of Microbiology, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
authors: Rushika
authors: R
authors: Saksena
authors: Department of Microbiology, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
authors: Vikas
authors: V
authors: Manchanda
authors: Address: Department of Pathology, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
authors: Ruchika
authors: R
authors: Gupta
keywords: Aspiration cytology; culture; lymphadenitis; tuberculosis