Role of fine‐needle aspiration cytology and fluid cytology in extra‐pulmonary tuberculosis

Abstract

Extra-pulmonary tuberculosis is the presence of disease in an organ without obvious involvement of the lungs (World Health Organization, Tuberculosis Fact sheet, 2006). The present article focuses on the incidence of extra-pulmonary tuberculosis as an emerging and clinically significant disease to be reckoned with in the present era. It also highlights fine-needle aspiration cytology (FNAC) as an inexpensive, less invasive procedure for early diagnosis of such tuberculosis and timely initiation of specific therapy. All cases of proved tuberculosis presenting to the M.V.J. Medical College and Research Hospital were recorded over a period of two years (2008-2010); and categorized as pulmonary and extra-pulmonary cases. A total of 96 cases of tuberculosis were observed; extra-pulmonary tuberculosis was seen in 64 cases. Of these 56 cases were from lymphnodes and 8 from extra-nodal sites which included tuberculous dactylitis (two cases), tuberculous mastitis (two cases), tuberculous synovial effusion (one case), pericardial effusion (one case), epididymo-orchitis (one case), and cold abscess (one case). The cytology patterns observed included granulomatous inflammation and necrosis with or without acid fast bacilli.

Comparison of the Microwave-Heated Ziehl-Neelsen Stain and Conventional Ziehl-Neelsen Method in the Detection of Acid-Fast Bacilli in Lymph Node Biopsies

“…This study showed that all cases in classical ZN method demonstrated granuloma with giant cells while this was demonstrated in 73.5% and 75.3% in fluorescence and the modified method respectively, Such findings have been previously reported by some authors (Ahmed, Vincent) [18], [19]. However, the absence of a characteristic histopathological picture of TB does not imply the absence of the disease [20].…”

Comparision of ZN Staining and Fluorescent Microscopy in Detection of Acid Fast Bacilli in Fine Needle Aspiration Smears

“…3 The key to control TB is its rapid detection. 4 Fine Diagnosis of tuberculous lymphadenitis still faces many challenges as the above appearances may be a morphological picture of other diseases, for example: necrosis can be a feature of the malignant neoplasm 7 , a full proof evidence of tuberculosis can only be made by the detection of acid-fast organism as the cause for granulomatous inflammation.In this study, two methods of detecting acid-fast organism is being used for optimal results to detected the presence of acid-fast bacilli (AFB) that are First is Ziehl-Neelsen (ZN) method and second byFluorescent method Ziehl-Neelsen staining method is the most important tool in the diagnosis of tuberculosis in direct microscopic examination of appropriately stained smears for Acid-fast bacillus. 4 Even though this technique is simple, inexpensive and detects those cases of tuberculosis, which are infectious, the drawback of this method it that it is a time consuming process for staining as well as examination.…”

Tuberculous Dactylitis: An Unusual Finding Demanding Invasive Diagnosis

“…Granulomata in synovial biopsy are present in about 80% of patients; synovial fluid culture is positive in 79% and synovial tissue culture in about 90%. The Ziehl Neelsen stain is reported negative in most previous cases [7], when the biopsy is obtained using a fine needle. In our case, even the surgical biopsy was of low yield in that regard.…”