CLINICOPATHOLOGICAL STUDY OF CORRELATION BETWEEN FNAC SMEAR , ZN STAINED SMEAR & HIV STATUS IN CLINICALLY SUSPECTED CASES OF LYMPH NODE TUBERCULOSIS IN URBAN EASTERN INDIA

Abstract

BACKGROUND: Tuberculous lymphadenitis (TBL) is the commonest form of extra pulmonary tuberculosis. Fine Needle Aspiration Cytology (FNAC) is a simple outpatient diagnostic procedure used in the diagnosis of TBL and all stages of Human Immunodeficiency Virus (HIV) infection are associated with increased risk of tuberculosis (TB). AIM & OBJECTIVE: To correlate different cytomorphologies of FNAC smears and presence or absence of Acid fast bacilli (AFB) in the Ziehl Neelsen (ZN) stained smear prepared from the same aspirate. Association of HIV infection are also to be evaluated. METHOD: An observational cross-sectional study was conducted at department of pathology in collaboration with department of pulmonary medicine, Medical College & Hospital, Kolkata from January 2015 to June 2016.It included 305 cases with enlarged palpable lymph nodes. FNAC done; aspirated smears were stained with papanicolaou, Leishman-Giemsa and ZN stains. HIV status were also noted. RESULTS: 251 aspirates were reported on cytomorphology as suggestive of TBL with 117 (47.01 %) AFB positivity in ZN stained smears. Cervical lymph node were most commonly involved site (86.84 %) and females (63.75%) were affected more than males (36.25%).Most cases of AFB positive smears were associated with caseation necrosis only (71.8 %). 17 (6.77 %) out of 251 cases were co infected with HIV. CONCLUSION: Special stains should be done in all suspected cases of TB lymphadenitis and most common cytomorphology associated with AFB positivity is caseation necrosis without granuloma. Also it can be concluded that TB/HIV co infection is not predominant in India.