Background: Conventional transbronchial needle aspiration (c-TBNA) is a minimally invasive bronchoscopic technique used to obtain cytological samples from peribronchial lesions and mediastinal lymph nodes. However, the concern about its efficacy and the advent of newer techniques have led to the underutilization of this time tested and cost-effective modality. Objective: The present study was aimed to assess the diagnostic yield of c-TBNA in suspected cases of lung cancer. Method: c-TBNA smears received from January 2017 to February 2020, with clinical-radiological suspicion of lung malignancy were retrospectively analyzed. Result: A total of 22 cases were reviewed. The mean age of the study population was 57.54 years, with a male-female ratio of ~2:1. The adequate aspirate was obtained in 19/22 (86%) cases. The overall diagnostic yield of c-TBNA was 82%. 14/19 (74%) cases were positive for malignancy, non-small cell lung carcinoma being the most common malignancy diagnosed (11 cases). 4/19 (21%) cases were diagnosed with granulomatous pathology, while smears in 1 case were non-diagnostic. Conclusion: Conventional transbronchial needle aspiration cytology is an efficacious method used for the diagnosis of lung carcinoma. Especially in resource-limited settings, it remains irreplaceable as a diagnostic tool and should be routinely utilized.
Background: Tuberculosis (TB), a communicable disease, caused by Mycobacterium tuberculosis requires a simple, rapid test, which can be easily carried out in a laboratory. Unfortunately, despite a battery of investigations, no definite test is available till date. Adenosine deaminase (ADA), a biochemical marker has been proposed as a useful surrogate marker for TB as its levels can be measured in body fluids. Methods: A one-and-a-half-year prospective study of 154 cases presenting with lymphadenitis from January 2019 to June 2020 was undertaken. Using cytology, lymphadenitis subjects were divided into two groups: Tubercular (104 patients) as a case group and Reactive (50 patients) as a control group. All cases were followed by serum ADA assay by colorimetric method. Nonparametric tests were performed to compare the two groups. Results: The mean age of the participants was 28.99 ± 13.26 years with a F:M ratio of 1.81:1. Involvement of cervical lymph nodes was most frequent (89.42% cases). The mean S.ADA level for tubercular and reactive lymphadenitis was 41.71 ± 11.53 U/L and 21.16 ± 4.16 U/L, respectively (P-value < 0.05). The cut-off value calculated was 32.6 U/L. The sensitivity, specificity, PPV, NPV, and accuracy were calculated as 79.81%, 100%, 100%, 70.42%, and 86.36%, respectively. Conclusion: A statistically significant increase was found in serum ADA levels in tubercular lymphadenitis cases compared to reactive lymphadenitis. Hence, it can be used as an adjunct to FNAC and is a fairly sensitive and specific test. Since it is difficult to always demonstrate AFB in FNAC smears, ADA can be helpful in establishing a definite diagnosis despite smear negativity. Keywords: adenosine deaminase, lymphadenitis, tuberculosis
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