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Diagnosis of tuberculous lymphadenitis: combining cytomorphology, microbiology and molecular techniques - a study

Lakmini K B Mudduwa1, Ajith de S Nagahawatte

  • 1Department of Pathology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka. lakminimudduwa@yahoo.com

Indian Journal of Pathology & Microbiology
|July 8, 2008
PubMed

Insights

Fine needle aspiration cytology (FNAC) is valuable for diagnosing tuberculous lymphadenitis. Combining epithelioid cells with caseation or Ziehl Neelsen stain offers the best diagnostic accuracy and agreement with culture results.

Area of Science:

  • Medical diagnostics
  • Infectious diseases
  • Cytopathology

Background:

  • Tuberculous lymphadenitis diagnosis relies on early detection.
  • Fine needle aspiration (FNA) is a minimally invasive method for obtaining diagnostic samples.

Purpose of the Study:

  • To evaluate the diagnostic utility of fine needle aspiration cytology (FNAC) for tuberculous lymphadenitis.
  • To compare FNAC findings with culture results as the gold standard.

Main Methods:

  • 43 aspirates from suspected tuberculous lymphadenitis cases were analyzed.
  • Samples underwent FNAC, Ziehl Neelsen staining, and Middlebrook media culture.
  • Diagnostic criteria agreement and predictive values were assessed using Kappa statistics.

Main Results:

  • Epithelioid cells with caseation or positive Ziehl Neelsen stain showed highest agreement (Kappa 0.84) and predictive values.
  • Positive Ziehl Neelsen alone yielded 100% positive predictive value but lower agreement.
  • Epithelioid cells alone had high negative predictive value (93.35%).

Conclusions:

  • The presence of epithelioid cells, with either caseation or positive Ziehl Neelsen stain, is the most reliable FNAC criterion.
  • This combined criterion demonstrates excellent agreement with culture and high predictive values for tuberculous lymphadenitis.
Abstract

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