Fine-needle aspiration cytology in a case with features of chronic granulomatous disease

Fine-needle aspiration cytology (FNAC) of enlarged cervical lymph nodes of a 9-yr-old boy complaining of progressive weight loss showed a combination of a necrotizing granulomatous process and pigmented histiocytes. The diagnosis of chronic granulomatous disease (CGD) of childhood was proposed, and it was later confirmed by histology. Although the NBT test was negative, the patient responded well to prolonged bactericidal therapy with trimethoprim-sulfamethoxazole associated with parenteral nutrition, indicating a rare case of CGD with a negative Nitro-Blue Tetrazolium (NBT) test. The cytologic findings appear to be unique for this disease.