Efficacy of Fine Needle Aspiration Cytology, Ziehl-Neelsen Stain and Culture (Bactec) in Diagnosis of Tuberculosis Lymphadenitis

Background: Tuberculous Lymphadenitis is the commonest form of extra pulmonary tuberculosis and tissue diagnosis is the main stay in the diagnosis of extra-pulmonary tuberculosis. This study was conducted to compare cytology, ZN staining and culture findings of clinically suspected tuberculosis lymphadenitis cases. Methods: In the Present Study clinically suspected cases of Lymphadenopathy were undergone Fine Needle Aspiration. The aspirate were examined cytologically followed by ZN staining and BACTEC culture. Results: The cytology suggestive of tuberculous lymphadenitis was found in 46(76.6%) cases out of total 61 cases. Ziehl Neelsen stain demonstrated acid fast bacilli (AFB) in 14 (22.9%) cases and BACTEC isolated mycobacteria in 36 (59%) cases. Out of 61 cases as many as 15(24.5%) cases yielded pus and in 13 of those cases cytology of tuberculous lymphadenitis was found. Cases from blood mixed aspirate demonstrated AFB positivity in 2 (5.88%) and mycobacteria were isolated in 16 (48.48%) cases and cytology also suggest least numbers of tuberculous lymphadenitis i.e. 21 (63.63%) cases. Seven out of Nine cases of necrosis with or without neutrophils show presence of AFB. Samples having epithelioid cell granuloma with or without necrosis show presence of AFB in 5 (16.66%) and 2 (25%) cases and mycobacteria was isolated in 22 (73.73%) and 5 (62.5%) cases respectively. Conclusion: In spite of the diagnostic pitfalls, the results obtained on analytical examination of the study carried out reinforce the opinion that Fine Needle Aspiration Cytology serves as a potent and accurate diagnostic tool for patients presenting with Lymphadenopathy due to tuberculosis.