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2014 ; 4
(3
): 393-6
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Cytomorphological patterns of tubercular lymphadenitis revisited
#MMPMID24971215
Hemalatha A
; Shruti P
; Kumar MU
; Bhaskaran A
Ann Med Health Sci Res
2014[May]; 4
(3
): 393-6
PMID24971215
show ga
BACKGROUND: Tubercular lymphadenitis is one of the most common causes of lymph
node enlargement in developing countries. Fine needle aspiration cytology (FNAC)
plays an important role in diagnosing Tubercular lymphadenitis and prevents
unnecessary surgical intervention. AIM: To study the cytomorphological patterns
of tubercular lymphadenitis in our study population and correlate the bacillary
load by acid fast staining with cytomorphological patterns. MATERIALS AND
METHODS: A total of 150 cases of cytological proven granulomatous lymphadenitis
and cases without granuloma, but positive acid fast bacilli (AFB) on Ziehl
Neelson (ZN) stain were included in our study. Cytomorphological patterns were
categorized into four patterns. Pattern A - Epithelioid granuloma without
necrosis, Pattern B - Epithelioid granuloma with necrosis, Pattern C - Necrosis
without epithelioid granuloma with neutrophilic infiltrate. Pattern D - with
numerous macrophages. Chi-square test was done to correlate cytomorphological
pattern and bacillary load. A 2 × 2 analysis was done to test the degree of one
hypothesis. A P < 0.05 was considered as significant. RESULTS: PATTERNS AND THE
NUMBER OF CASES OBSERVED ARE AS FOLLOWS: Pattern A - 29 cases, Pattern B - 84
cases, Pattern C - 34 cases. A distinct D Pattern with abundant foamy macrophages
was seen in three immunodeficient patients. Positive ZN staining was seen in
81/150 54% of cases. The cytological patterns of AFB positive cases Pattern A:
6/29 (21%), Pattern B: 46/84 (55%), Pattern C: 25/34 (73.5%), Pattern D: 4/4
(100%). CONCLUSION: FNAC is useful in diagnosing tubercular lymphadenitis.
Maximum bacillary load was seen in Pattern C. A distinct D Pattern was seen in
immunodeficient patients.