Cytomorphological Patterns in the Diagnosis of Tuberculous Lymphadenitis

Khanna, Ashish K.; Khanna, Menka; Manjari, Mridu

doi:10.19056/ijmdsjssmes/2013/v2i2/86779

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…In the present study, the most common cytomorphological pattern observed on FNAC was that of well-formed epithelioid cell granulomas with caseous necrosis (34%). This was in agreement with the studies done by Laishram et al, 11 Shirish et al, 12 Khanna et al, 13 Thakur et al, 14 Mitra et al, 15 and Naaz et al, 16 Most cases of tubercular lymphadenopathy were observed to occur between 20-59 years of age in the present study, this was comparable with the study by Muluye et al, 17 who documented 54.6% cases in the adult age group (25-60 years) while Singh et al, 18 observed that the maximum number of the patients were between 20-40 years. Similar observations were made by Gupta et al, 4 and Jasim et al 19 Out of the total of 330 cases, females were more frequently diagnosed as suffering from tubercular lymphadenopathy (189 cases,57.3% of all).…”

Section: Discussionsupporting

confidence: 93%

A comparative study of the role of cytopathology, staining for acid-fast bacilli and genexpert MTB/RIF assay in the diagnosis of tubercular lymphadenopathy

Ahmed

Ansari²,

Fatima³

2022

JDPO

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The diagnosis of tubercular lymphadenopathy can be made by FNAC combined with staining for AFB along with newer methods like GeneXpert assay. India carries one of the largest burdens of TB accounting for twenty-seven per cent of worldwide cases. To evaluate the role of cytopathology, AFB staining and GeneXpert assay in the rapid diagnosis of tubercular lymphadenopathy along with the usefulness of GeneXpert assay in the diagnosis of indeterminate aspirates. A total of 372 patients presenting with lymphadenopathy and clinical suspicion of a tubercular aetiology were included in the analysis.183 patients (56%) were adults (20-59 years) followed by 66 patients (20%)in the paediatric age group. 189 were females(57.3%) and 141 were males (42.7%). The cervical group of lymph nodes were most commonly involved (66%).69.1% were AFB positive in 201 smears with features favouring tubercular infection (positive cytology) which increased to 183 (91%) when GeneXpert Analysis was done, while 72 cases (55.8%) were AFB positive on cases with indeterminate cytology which showed an increment to 108 cases (83.7%) on the application of GeneXpert. FNAC combined with ZN staining and GeneXpert has a much higher diagnostic accuracy, GeneXpert further prevents underdiagnosis and enables rapid and accurate diagnosis in cases with indeterminate/inconclusive FNAC and ZN staining.

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Section: Discussionsupporting

confidence: 93%

A comparative study of the role of cytopathology, staining for acid-fast bacilli and genexpert MTB/RIF assay in the diagnosis of tubercular lymphadenopathy

Ahmed

Ansari²,

Fatima³

2022

JDPO

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“…The commonest pattern in this study was pattern B (66.34% cases) showing epithelioid granuloma with necrosis. The same was observed by Bhattacharya et al[18] and Khanna et al[19] in 69.4% and 50.5% cases, respectively.Results similar to our study were also demonstrated in the studies by Sulakshana et al[21], Ahmed et al[22], Abdelsadek et al[23], Mugulkod et al[15], and Stevanovic et al[3]. This was in contrast to the findings of Conde et al[22].…”

supporting

confidence: 87%

Association of Serum Adenosine Deaminase Levels in Cytologically Suggested Cases of Tubercular Lymphadenitis: The Experience of a Tertiary Care Centre

Garg

Arora

Joshi

et al. 2021

SJMS

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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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“…The most common cytomorphological pattern observed in our study was epithelioid granuloma with necrosis, seen in 53.17% cases. This was also the commonest pattern in the study by Khanna A et al, Bhattacharya S et al and Prasoon D et al [14][15][16] They reported this pattern in 50.5%, 69.4% and 44.2% of cases respectively. The presence of caseous necrosis without epithelioid granuloma was the least common pattern in our study, seen in 8.73% cases.…”

Section: Discussionmentioning

confidence: 59%

Cytopathological patterns of tuberculous lymphadenitis: an analysis of 126 cases in a tertiary care hospital

Bhatta¹,

Singh²,

Chalise³

2018

Int J Res Med Sci

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Background: Tuberculous lymphadenitis is one of the most common causes of lymphadenopathy in developing countries. Fine needle aspiration cytology (FNAC) has important role in the diagnosis of tuberculous lymphadenitis. The objective of this study was to evaluate the cytopathological patterns of tuberculous lymphadenitis and to correlate with Ziehl-Neelsen (ZN) staining.Methods: FNAC of 126 cases diagnosed as tuberculous lymphadenitis over a period of three years were reviewed. FNAC findings were categorized into three patterns: pattern A- epithelioid granuloma without caseous necrosis, pattern B- epithelioid granuloma with caseous necrosis, pattern C- caseous necrosis without epithelioid granuloma. Chi-square test was done to correlate cytopathological pattern and acid fast bacilli (AFB) positivity.Results: Tuberculous lymphadenitis was most frequent in the age group of 21-30 years (40.5%). Most common lymph node involved was cervical lymph node (82.53%). The most common pattern observed was Pattern B- Epithelioid granuloma with caseous necrosis in 53.17% cases. Overall AFB positivity was seen in 34.92% cases. Maximum AFB positivity was seen in Pattern C- Caseous necrosis without epithelioid granuloma in 81.81% cases. Serum adenosine deaminase (ADA) was elevated in 66.66% patients.Conclusions: FNAC is safe and cost effective diagnostic tool for the diagnosis of tuberculous lymphadenitis. Ziehl-Neelsen stain for Acid fast bacilli and Serum ADA can be used as an adjunctive tool for the diagnosis of tuberculous lymphadenitis.

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Cytomorphological Patterns in the Diagnosis of Tuberculous Lymphadenitis

Abstract: ABSTRACT

Cited by 5 publications

References 8 publications

A comparative study of the role of cytopathology, staining for acid-fast bacilli and genexpert MTB/RIF assay in the diagnosis of tubercular lymphadenopathy

A comparative study of the role of cytopathology, staining for acid-fast bacilli and genexpert MTB/RIF assay in the diagnosis of tubercular lymphadenopathy

Association of Serum Adenosine Deaminase Levels in Cytologically Suggested Cases of Tubercular Lymphadenitis: The Experience of a Tertiary Care Centre

Cytopathological patterns of tuberculous lymphadenitis: an analysis of 126 cases in a tertiary care hospital

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