Study of Incidence and Cytomorphological Patterns of Tubercular Lymphadenitis in a Secondary Care Level Hospital of Jammu Region

Background: Tuberculosis is still a global health concern. Most common presentation of extra pulmonary tuberculosis is tubercular lymphadenitis. In our setting, keeping huge burden of tuberculosis in mind, clinicians have to rely on pathological diagnosis of enlarged lymph nodes i.e. cytomorphology with acid fast staining in diagnosing these cases so that diagnosis and management of such cases can be initiated quickly. Fine needle aspiration cytology (FNAC) of lymph nodes has been a simple, rapid and cost effective procedure for diagnosis of various causes of lymphadenopathies. Our study is the first one in its type in J&K reporting the incidence and pattern of Tubercular Lymphadenitis in secondary level health care hospital. Aims: To report the incidence and describe various cytomorphological patterns of tubercular lymphadenitis in secondary care level Government Hospital, Gandhi Nagar, Jammu. Material and Methods: In a study period of two and a half years, two hundred and thirty one consecutive enlarged lymph nodes were aspirated and subjected to cytomorphological evaluation with Papanicolaou(PAP), Giemsa ,and Ziehl- Neelsen (Z-N) stained smears. Results: Incidence of tubercular lymphadenitis was reported as 34.6% (C.I 0.285-0.411). Around 80% of cases were in the second to fourth decades of life with mean age as 27.08 years and male to female ratio of 1:1.6 .Cervical region was the most common site of involvement with multiple unilateral lymphadenopathy as the most common presentation. The most common cytological picture was epithelioid granulomas with caseous necrosis (52.5%). Overall AFB positivity was seen in 65% cases. Conclusions: FNAC has proved as a very useful first line of investigation in patients presenting with lymphadenopathy, especially in secondary care centres.