DOI: 10.36347/sjams.2015.v03i03.104

Pages: 1547-1552

Tuberculous lymphadenitis is the commonest cause of lymphadenopathy in developing countries. Cytomorphology along with acid fast staining plays an important role in diagnosing these cases, thus avoiding unnecessary surgical intervention. The aim is to study the epidemiological patterns and cytomorphological presentations of tuberculous lymphadenitis in reference to Ziehl- Neelsen staining. This was a retrospective study and a total of 891 patients including all age groups and both sexes presenting with palpable or deep lymph nodes in fine needle aspiration cytology (FNAC) clinic of our institute over a period of 2 years and four months were included in the study. Smears were fixed in 95% ethyl alcohol and stained with Papanicolaou stain. Leishman stain was done on air dried smears. ZiehlNeelsen(ZN) staining was done wherever required. During this period, 500 cases of Tuberculous lymphadenitis were diagnosed on cytology. These were further categorised into three patterns based on cytomorphological features and the percentage of acid fast bacilli (AFB) positive cases in each category were noted. Data was entered in excel spread sheet and statistical analysis was done. P value <0.05 was taken to represent significant difference. Out of 891 aspirations from lymph nodes, 500 cases were diagnosed as Tuberculous lymphadenitis. Three cytomorphological patterns were observed. These were- Group 1: Granulomas without necrosis (26.6%), Group 2: Caseating epithelioid Granulomas (66%), Group 3: Necrotizing lymphadenitis (7.4%). Overall, AFB positivity was seen in 21.6% cases. The incidence of Tuberculous lymphadenitis in our study population is significantly high. FNAC is useful in diagnosing Tuberculous lymphadenitis and its sensitivity can further be increased by complementing cytomorphology with acid fast staining.