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Tuberculous lymphadenitis: extended cytomorphologic features
A A Pandit1, P H Khilnani, A S Prayag
1Department of Pathology, Seth Gordhandas Sunderdas Medical College, Parel, Bombay, India.
Diagnostic Cytopathology
|February 1, 1995
Summary
Eosinophilic structures (ES) in fine-needle aspiration cytology (FNAC) can aid tuberculosis diagnosis when granulomas are absent. These structures are identified as degenerated granulomas, offering an extended diagnostic criterion for tuberculous lymphadenitis.
Area of Science:
- Pathology
- Cytology
- Infectious Diseases
Background:
- Tuberculous lymphadenitis diagnosis can be challenging with fine-needle aspiration cytology (FNAC) when only caseous necrosis is present without epithelioid cell granulomas.
- Acid-fast bacilli (AFB) staining may be negative in such cases, posing a diagnostic dilemma.
Purpose of the Study:
- To investigate the nature of eosinophilic structures (ES) observed in FNAC smears.
- To determine the diagnostic role of ES in tuberculosis.
Main Methods:
- Analysis of seventy FNAC smears from confirmed tuberculous lymphadenitis cases.
- Classification of smears based on cytomorphological features, noting the association of ES with other criteria.
- Immunoperoxidase staining to assess ES reactivity to tuberculous antigen and compare positivity intensity with granuloma types.
Main Results:
- Eosinophilic structures (ES) were identified as pink, homogenous structures with irregular shapes and defined margins.
- ES were found to be degenerated granulomas.
- Immunoperoxidase staining confirmed the reactivity of ES to tuberculous antigen.
Conclusions:
- Eosinophilic structures (ES) represent degenerated granulomas.
- ES serve as an extended diagnostic criterion for tuberculous lymphadenitis, particularly when granulomas are not clearly identifiable.