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EFFICACY OF FINE NEEDLE ASPIRATION CYTOLOGY, ZIEHL-NEELSEN (Z-N) STAIN AND CULTURE (BACTEC) IN DIAGNOSIS OF TUBERCULOSIS LYMPHADENITIS

Keywords: Fine Needle Aspiration Cytology , Ziehl-Neelsen Staining , BACTEC culture , chronic cervical lymphadenitis.

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Abstract:

Background- Tuberculous Lymphadenitis is the commonest form of extra pulmonary tuberculosis and tissue diagnosis is the main stay in the diagnosis of extra-pulmonary tuberculosis. This study was conducted to compare cytology, ZN staining and culture findings of clinically suspected tuberculous lymphadenitis cases. Methods- In the Present Study, clinically suspected cases of lymphadenopathy were undergone fine needle aspiration. The aspirates were examined cytologically followed by ZN staining and BACTEC culture. Results- The cytology suggestive of tuberculous lymphadenitis was found in 46 (76.6%) cases out of total 61 cases. Ziehl Neelsen stain demonstrated positive for acid fast bacilli (AFB) in 14 (22.9%) cases and mycobacteria isolated from BACTEC in36 (59%) cases. Out of 61 cases 15(24.5%) cases showed pus formation and in cytological examination 13 of those cases reported as tuberculous lymphadenitis. Aspiration mixed with blood demonstrated AFB positive in 2 (5.88%) and mycobacteria were isolated in 16 (48.48%) cases and cytology suggest tuberculous lymphadenitis in 21 (63.63%) cases. Seven out of Nine cases of necrosis with or without neutrophils show presence of AFB. Samples having epithelioid cell granuloma with or without necrosis show AFB positive in 5 (16.66%) and 2 (25%) cases and mycobacteria isolated in 22 (73.73%) and 5 (62.5%) cases respectively. Conclusion- In spite of the diagnostic pitfalls, the outcomes of this study reinforce the importance of opinion i.e. Fine Needle Aspiration Cytology serves as a potent and accurate diagnostic tool forpatients presenting with Lymphadenopathy due to tuberculosis.

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