DIAGNOSIS OF TUBERCULAR LYMPHADENITIS AND ABSCESS: A SPECTRUM OF CYTOMORPHOLOGICAL FINDINGS AND INCIDENCE OF ACID FAST BACILLI POSITIVITY

*Prachi Kukreja and Shubhra Agarwal

ABSTRACT

Context: Tuberculosis persists to be a major health burden world wide. Extrapulmonary tuberculosis most commonly presents as tubercular lymphadenitis. Fine needle aspiration cytology and Ziehl Neelsen staining are valuable and cost effective tools for diagnosing this health problem in a large population. Aims: To describe the cytomorphological findings in cases suspected to be of tubercular aetiology on Giemsa stained smears and to find the incidence of acid fast bacilli positivity in these cases. Settings and Design: It was a prospective type of study done in a Secondary care level hospital of Delhi, India. Methods and Material: Over a period of 16 months, 498 cases which were cytologically suspected to be of tubercular aetiology on Giemsa stained smears were included in this study. These cases were further subjected to evaluation for acid fast bacilli positivity on Ziehl Neelsen stained smears. Results: Total number of cases included in the study were 498. Out of these 174 (35%) were male and 324 (65%) were female patients. The most common age group was 11-20 years. Cervical region was the most common site involved. The most common cytological finding seen in smears was abscess (polymorphs with necrosis). Acid fast bacilli (AFB) positivity was seen in overall 363 (73%) cases. Conclusions: Tuberculosis still persists to be a major health problem in developing countries like India. Clinicians rely on confirmatory pathological and Ziehl Neelsen stain findings for commencing Anti Tubercular Treatment. Fine needle aspiration cytology (FNAC) accompanied by AFB positivity are less invasive, accurate and cost effective tools for diagnosing tuberculosis, therefore becoming the primary diagnostic modalities of choice in secondary care level hospitals.

Keywords: Tuberculosis, Extrapulmonary, Cytomorphology, Ziehl Neelsen.