Frequency of Tuberculosis in Patients with Enlarged Lymph Nodes and its cost-effective first line of Diagnosis in our Country

Abstract

Tuberculosis is the commonest infectious disease in the developing world. Tuberculous lymphadenitis is one of the most common form of extrapulmonary tuberculosis.Many diagnostic tests are devised for its detection including direct smear examination. This cross-sectional study was designed to determine the frequency of tuberculosis in lymphadenopathy of different sites and its rapid diagnosis by FNAC and ZN(ZiehlNeelsen)staining of aspitation smears. A descriptive cross-sectional survey was done on 100 cases of enlarged lymphnodes on different site at two private tertiary medical college hospital of Dhaka. After reporting granulomatous inflammation on papanicolaou staining (PAP stain) of aspirates obtained by FNAC, one unstained slide from each cases was subjected to special stain like ZN, to determine the AFB positivity. Cases positive for AFB on ZN stain were noted down along with their frequency and percentages. Cervical lymph nodes were the most commonly involved site (76%). Forty One cases (56%) of AFB positive smears were reported in granulomatous inflammation. Most cases of AFB-positive smears were associated with caseation necrosis (92%). Male were affected more (63%) than female. Fine Needle Aspiration Cytology (FNAC) is a simple and rapid diagnostic technique, along with ZN staining, that increases the diagnostic accuracy of this technique. Because of early availability of results, simplicity, minimal trauma and complications, the aspiration cytology is now considered a valuable diagnostic aid and is part and parcel of a pathologist's repertoire.

Histopathology of extra-pulmonary tuberculosis at pathology lab of Patan Hospital, Nepal

“…This is consistent with other studies from south Asian countries with similar socio-economic status and health care system. 2,4,6,7 The similar results are due to the related condition of the host and the environmental association in this region. 1 The most common mode of development of tuberculous lymphadenitis is a reactivation of healed focus and progression of primary tuberculosis.…”

“…In Nepal and other developing countries, peripheral lymph nodes continue to be the most common form of EPTB. 4 "Scrofula" meaning "glandular swelling" (Latin) 5 , tuberculous lymphadenitis has been recognized for the last 3,000 years. Peripheral lymph nodes are most often affected; among which cervical involvement is the most common.…”

“…Peripheral lymph nodes are most often affected; among which cervical involvement is the most common. [2][3][4][5][6] Extrapulmonary tuberculosis (EPTB) is defined by WHO as a case of TB involving organs other than the lungs.…”