Role of fine needle aspiration cytology as a diagnostic tool in lymphadenopathy with utility of CBNAAT in tuberculous lymphadenopathy

Introduction: Lymphadenopathy is a common, nonspecific clinical sign. Fine Needle Aspiration Cytology (FNAC) is the first line of investigation in the evaluation of lymphadenopathy. FNAC material can be used for cytological evaluation and other ancillary tests in Tuberculous Lymphadenopathy. Aims and Objectives To evaluate the role of FNAC as a diagnostic tool in lymphadenopathy. To assess the role of Cartridge based nucleic acid amplification test (CBNAAT) in suspected cases of tuberculous lymphadenopathy. Materials and methods: The study conducted at department of Pathology in MVJMC &RH, Hoskote, Bangalore from January 2017 to June 2018 A total of 104 cases of lymphadenopathy were subjected to FNAC. In each case at least 3 smears for H & E, Giemsa stain and Special stain like AFB done for tuberculous lymphadenopathy. FNAC material sent for CBNAAT in suspected cases of Tuberculosis . Results: The age ranged from 1-90years, Male:Female of ratio1.26 :1. Most common site was cervical and cytological pattern was granulomatous -41(39.4%) followed by reactive -38(36.5%).Majority of them presented with solitary node (77%) and followed by bilateral/multiple (23%). One case of reactive (11%), two cases of suppurative (50%) and ten cases of granulomatous (37%) were found to be positive for Tuberculosis by CBNAAT. Conclusion: FNAC is simple, cost effective diagnostic tool with high degree of accuracy.FNAC coupled with AFB staining is the first line of investigation for Tuberculous lymphadenopathy. According to New Revised National TB Control Programme (RNTCP) guidelines CBNAAT sputum is a must for paediatric cases. The present study highlights the utility of CBNAAT from FNAC material as one of the rapid and adjuvant diagnostic tool in tuberculous lymphadenopathy.