Sunil Vitthalrao Jagtap 1 , Swati Sunil Jagtap 2 , Vidya Chandrashekhar Aher 3
ABSTRACT: BACKGROUND: Tuberculosis remains most common infectious disease in the developing world. Cytomorphological studies with detection of acid fast bacilli prove to be valuable diagnostic method in case of tuberculosis lymphadenopathy. AIMS: To study the various cytomorphological patterns of tuberculous lymphadenopathy and role of Ziehl-Neelsen stain (ZN) to detect acid fast bacilli (AFB). MATERIAL AND METHOD: This study was descriptive, cross-sectional and analytical, conducted at Krishna hospital and medical research centre, tertiary care and rural hospital from a period of January 2014 to December 2014. Patients with lymphadenopathy having clinical suspicion of tuberculosis were referred to Pathology department for cytopathological evaluation. Clinical presentation, routine investigations and fine needle aspiration cytology (FNAC) smear study with Hematoxylin and eosin, Giemsa and Ziehl-Neelsen stain was done. RESULT: In this study total 135 patients of lymphadenopathy were studied for aspiration cytology. Incidence of tuberculous lymphadenitis was noted in 52 cases (38.51 %). The cervical group of lymph node enlargement was most common site. Most patients presented in 21 to 30 years of age group with M:F ratio 1.2:1. The most common cytological feature was epithelioid granuloma without necrosis was in 25 cases (48.07%). Others were epithelioid granuloma with caseous necrosis in 16 cases (30.76%), necrosis without granuloma in 6 cases (11.52%) and polymorphs with necrosis with/ without epithelioid granuloma seen in 5 cases (9.61%).AFB positivity was noted in 17 cases (32.69%). CONCLUSION: FNAC is a very important investigation in diagnosis of tuberculous lymphadenitis, if it is supported with ZN stain for AFB will help to confirmatory diagnosis of the disease and for better management of the patients.