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Fine needle aspiration cytodiagnosis of toxoplasmic lymphadenitis
1Department of Laboratory Services, Wellington Hospital and School of Medicine, New Zealand.
Insights
Toxoplasmic lymphadenitis, a common cause of unexplained swollen lymph nodes, can be diagnosed using fine needle aspiration cytology. This method confirms the presence of Toxoplasma gondii and can avoid invasive procedures.
Area of Science:
- Medical Microbiology
- Cytopathology
- Infectious Diseases
Background:
- Toxoplasmic lymphadenitis is a frequent cause of cervical lymphadenopathy.
- Diagnosis often relies on clinical suspicion and invasive procedures.
Purpose of the Study:
- To evaluate fine needle aspiration cytology (FNAC) for diagnosing toxoplasmic lymphadenitis.
- To correlate cytological findings with serological confirmation.
Main Methods:
- Six cases of suspected toxoplasmic lymphadenitis were analyzed.
- Cytological samples were prepared from needle washings and smears.
- Cell blocks were processed for histological examination.
- Serological testing for Toxoplasma gondii was performed.
Main Results:
- Cytological examination revealed characteristic features including a polymorphous cell population and intracellular organisms resembling Toxoplasma gondii.
- All cases showed elevated Toxoplasma antibody titers upon serological testing.
- Cytohistologic findings were consistent with toxoplasmic lymphadenitis.
Conclusions:
- FNAC is a reliable method for diagnosing toxoplasmic lymphadenitis.
- Toxoplasmic lymphadenitis should be considered in cases of unexplained lymphadenopathy, particularly in the cervical region.
- Serological confirmation is recommended, and this self-limited condition typically requires no treatment.
- FNAC can obviate the need for hospitalization and surgery, offering a minimally invasive diagnostic approach.
Objective:
To study six cases of toxoplasmic lymphadenitis in which the diagnosis was made by fine needle aspiration cytology and confirmed by subsequent serology.
Study Design:
For cytologic study the material was received as needle and syringe washings, air-dried smears and alcohol-fixed smears, which were prepared and appropriately stained. Additionally, cell blocks were made, processed, cut and stained.
Results:
The cytohistologic features were characterized by a polymorphous population of cells, germinal centers, a few epithelioid-type cells and histiocytes with intracellular organisms resembling Toxoplasma gondii. Serologic testing for toxoplasma in all the cases revealed elevated titers.
Conclusion:
Lymphadenitis due to Toxoplasma infection is common and should be considered in the diagnosis of unexplained lymphadenopathy at all sites, especially the cervical region. Serologic confirmation should be recommended for all suspected cases of this self-limited condition, for which no treatment is necessary. Fine needle aspiration cytodiagnosis can eliminate the need for hospitalization and surgery.
