Cytopathological study of Tubercular Lymphadenopathy on FNAC: Analysis of 155 Consecutive Cases.

Volume : VII, Issue : VII, July - 2018

Dr. Anil Meena, Dr. Gajendra Pal Singh

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.

Aims: Our study was designed to evaluate the cytopathological pattern of FNAC from different anatomical sites of patients

presenting with lymphadenopathy with special reference to tuberculous lymphadenopathy.

Materials and Methods: In this study all the patients referred to the cytopathology lab for FNAC of lymph nodes between

January 2016 to december, 2017 were included. Out of 920 patients presenting with lymphadenopathies, there were 155 cases

of tuberculous lymphadenitis. The cytopathological findings of these 155 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 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 (48.38%). Maximum AFB positivity was seen in cases having caseous

necrosis only.

Conclusion: 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.