Cytomorphological pattern analysis of tubercular lymphandenopathies

Area of Science:

• Cytopathology
• Microbiology
• Infectious Diseases

Background:

• Tubercular lymphadenopathy presents diverse morphological patterns.
• Understanding these patterns is crucial for accurate diagnosis and management.
• Correlation with acid-fast bacilli (AFB) aids in confirming tuberculous etiology.

Purpose of the Study:

• To analyze the spectrum of cytomorphological patterns in tubercular lymphadenopathies.
• To correlate these patterns with the presence and load of acid-fast bacilli (AFB).
• To evaluate the diagnostic utility of Fine Needle Aspiration Cytology (FNAC) in tubercular lymphadenopathy.

Main Methods:

• FNAC smears from 210 cases of granulomatous lymphadenitis were analyzed.
• Stains used included Giemsa, Pap, and Hematoxylin & Eosin for cytomorphology.
• Zeihl Neelsen staining was employed for AFB detection.

Main Results:

• 193 cases showed necrotizing granulomatous inflammation or positive AFB.
• The most common cytomorphological patterns were epithelioid granuloma with caseous necrosis (Pattern A, 33.7%) and caseous necrosis with inflammation (Patterns B & C, 31.1% & 30.6%).
• AFB were detected in 90.7% of cases, with the highest bacillary load in Pattern C.

Conclusions:

• FNAC is a valuable and simple tool for diagnosing lymphadenopathies.
• Specific morphological patterns on FNAC suggest tuberculous etiology.
• Demonstration of AFB on aspirated material definitively confirms tuberculosis.