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Utility of acid fast staining and re-aspiration in tubercuhlar lymphadenopathy - 3 year study at tertiary centre

Atul Shrivastav, Harsh A Shah, Geetika Shrivastav, Pravina M. Santwani.

Abstract
Background: Tuberculosis is a great problem throughout the world, especially in developing countries like India. Beside pulmonary tuberculosis, extra pulmonary tuberculosis is relatively more common among the Asian population.

Aims & Objective: (1) To establishing the utility of performing Acid Fast Bacilli (AFB) on aspirated material; (2) To study the distribution of cytomorphological patterns of tuberculous lymphadenitis; (3) To study the role of repeat aspiration in diagnosing tuberculous lymphadenitis.

Material and Methods: The present study was conducted on 1022 patients of lymphadenopathy during the period of 36 months. Fine needle aspiration was performed in all the patients and 3 smears are made. One is kept unfixed for Ziehl Neelsen staining and other two are alcohol fixed and stained with Papanicolaou (Pap) stain and May Grunwald Giemsa (MGG) stain.

Results: Out of 1022 aspirations from lymph nodes 402 cases were diagnosed as tuberculous (TB) lymphadenitis. Three cytomorphological patterns were observed: group-1: Granulomas without necrosis (33.83%); group-2: Caseating epithelioid granulomas (43.03%); and group-3: Necrotizing lymphadenitis (23.13%). AFB positivity was seen in 44.02% cases. 125 cases were diagnosed as reactive lymphadenitis with activated histiocyte clusters were advised a repeat aspiration, out of these 55 cases showed subsequent development of epithelioid granulomas.

Conclusion: FNAC is a useful tool in the study of tuberculous lymphadenitis and repeat aspiration, after 2 3 weeks helps in providing the correct diagnosis of early tubercular lesions.

Key words: Fine Needle Aspiration Cytology; Tuberculosis; Caseating Epithelioid Granuloma; Necrotizing Lymphadenitis



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