Tuberculous Lymphadenitis and Cytological Methods

Volume : VIII, Issue : VI, June - 2018

Gopinath Rajesh

The investigations remain the cornerstone in diagnosis and treatment of tuberculosis, the choice of which depends on

socioeconomic strata in high burden countries. The use of molecular methods by western world has limited the usage of

cytological methods(FNAC) for treatment monitoring only. An effort is made here to highlight the efficiency of cytologic methods in the

evaluation of tuberculous lymph nodes. The burden of EPTB and the shift in trend over a period of time was also observed. The data was accessed

from RNTCP registers for EPTB proportion and departmental register for the cytomorphologic pattern. The EPTB burden currently was 47% in

our set–up with lymph nodes and pleura accounting for more than 50% of the cases, other sites in decreasing order of frequencies were abdominal,

osteoarticular, CNS and others. The cytological study portrayed epithelioid granuloma without necrosis as the most common morphological

pattern, a majority of them had blood–tinged aspirate with a paltry AFB positivity. The other two categories epithelioid granuloma with necrosis

and necrosis without granuloma had cheesy and purulent aspirates with a significant AFB positivity rate. The modern molecular methods have not

phased out the credibility of cytological (FNAC) methods for diagnosis of tuberculous lymphadenitis. Cytological methods still remains a sine

qua non for diagnosis especially in areas where facilities for molecular tests are not available.