A Comparative Study of Fluorescence Microscopy with Ziehl Neelsen Staining for Detection of Acid Fast Bacilli in Lymph Node Aspirates

Objective To study the cytomorphological features in fine needle aspiration smears from patients suspected of having tuberculous lymphadenitis using May Grunwald Giemsa (MGG) and Haematoxylin and Eosin stains and compare the efficacy of Ziehl Neelsen staining (ZN) and fluorescent staining for the detection of acid fast bacilli on lymph node aspirates. Materials and methods The present study was conducted in 100 patients presenting with peripheral lymphadenopathy suspicious of tuberculous lymphadenitis. Fine needle aspirations were performed and smears from the aspirates were processed for routine cytology, the conventional ZN method, and the fluorescent method. Results The smear positivity with ZN stain was seen in 37 % of cases while the positivity increased to 73 % with fluorescent method. Conclusion Fluorescent microscopy has the advantage of speed and ease of screening, and reduces observer fatigue. The fluorescent method was found to be more advantageous than routine cytology and conventional ZN method, particularly in paucibacillary cases.