Background: Tuberculous lymphadenitis is the most common manifestation of extrapulmonary tuberculosis. Fine needle aspiration cytology (FNAC) is a valuable tool in diagnosis of tubercular lymphadenitis. The present study aims to determine the prevalence of different cytomorphological patterns in fine needle aspiration cytology of tubercular lymph nodes and their correlation with Acid Fast Bacilli (AFB) positivity on Ziehi-Neelsen (ZN) Staining.Methods: Fine needle aspiration cytology of 274 cases diagnosed as tubercular lymphadenitis over a period of a year were reviewed. Cytomorphological patterns were categorized into three patterns. Pattern I: Epithelioid granuloma without necrosis, Pattern II: Epithelioid granuloma with caseous necrosis and Pattern III: Caseous necrosis only. Fischer Exact test was applied to correlate cytomorphological pattern and AFB positivity.Results: Tuberculous lymphadenitis was most frequent in age group 21-30 years (24.81%). Cervical lymph nodes were the most frequent lymph nodes involved (84.67%). Pattern I was the most common cytomorphological pattern observed (49.3%). Overall AFB positivity was 28.10%. Maximum AFB positivity was seen in pattern III (73.3%).Conclusions: FNAC is the simple, cost effective and minimally invasive tool to diagnose tuberculous lymphadenitis. Study of both cytomorphological pattern and ZN staining for AFB can improve the diagnostic accuracy.

Introduction Metastatic cervical lymphadenopathy is a diagnostic and therapeutic challenge. The utility of Fine Needle Aspiration Cytology is well established in the diagnosis of metastatic lymph nodes, new-onset, or recurrence. This study aims to find the prevalence of metastatic cervical lymphadenopathy among fine needle aspiration cytology in a tertiary care center in far western Nepal. Materials and Methods This is a descriptive cross-sectional study carried out in Seti Provincial Hospital and Maya Metro Hospital, Dhangadhi, Kailali, Nepal between July 2018 to December 2019. Total 534 cervical lymph node aspirations were performed during this period out of which 48 cases were cytologically proven as malignant lymph nodes. Clinical charts and cytology reports of patients with malignant lymph nodes were reviewed. Results Out of 534 cervical lymph node aspirations performed during the study period, the number of malignant lymph nodes was 48 (8.99%). Among malignant lymph nodes (n=48), primary hematolymphoid malignancy was 14 (29.17%) and metastatic cervical lymphadenopathy was 34 (70.83%). Metastatic squamous cell carcinoma was the most common etiology of metastatic cervical lymphadenopathy followed by nasopharyngeal carcinoma and papillary carcinoma of the thyroid. Conclusion Fine needle aspiration cytology has been proved to be a valuable tool in the initial evaluation of metastatic cervical lymphadenopathy in resource-limited settings. Metastatic squamous cell carcinoma is the most common diagnosis in metastatic cervical lymphadenopathy.

Introduction Chronic otitis media squamous is a gradually expanding destructive lesion and leads to complications by eroding the adjacent structures. Facial canal and ossicles are in close proximity in the middle ear space and they share the same pathogenesis of the bony erosion. Ossicular chain erosion found intraoperatively due to cholesteatoma, may suggest the likelihood of facial canal dehiscence. This study was conducted to assess the relationship between ossicular chain erosion and facial canal dehiscence in chronic otitis media squamous. MethodsIt is a retrospective chart review of patients who had mastoidectomy done for chronic otitis media squamous in Tribhuvan University Teaching Hospital from January 2014 to December 2018. The operative findings of facial canal dehiscence were correlated with ossicular chain status. ResultsAmong 158 cases, facial canal dehiscence was seen in 20 (12.7%), of which, 19/20 (95%) had ossicular erosion. Majority (90%) of dehiscence was in the horizontal segment. Incus was the most common ossicle to be eroded. Among the ossicles, stapes erosion was related to the facial canal dehiscence with odds ratio of 3.216 (1.235-8.374) and p-value 0.03. ConclusionAmong the ossicles, there is a relationship between the stapes erosion and the facial canal dehiscence in chronic otitis squamous. Erosion of ossicular chain especially stapes should alert surgeons towards the possibility of facial canal dehiscence.