Cyto-Morphological Pattern of Tuberculous Lymphadenitis among Sudanese Patients

This is a descriptive study carried out in Khartoum state hospitals, during the period from January 2013 to April 2014. The study aimed at assessing the cyto-morphological pattern of tuberculous lymphadenitis among Sudanese patients, and screening for cellular changes that accompany this condition. A total of 75 cytological samples (fine needle aspirates) were collected from different lymph nodes. All patients were previously diagnosed with tuberculous lymphadenitis. The samples were prepared, processed, and stained according to the conventional Papanicolaou staining method, then microscopically examined. The study revealed the following findings The age group of (41-60) were the most observed age which constitute 33 (44 %), and females 48 (64 %) were the most frequently observed subject. Western Sudanese tribe 26 (34.7 %) showed the major population among the study subjects. Caseating Epitheloid Granulomas is the major cytological pattern which found in 35 (46.7 %) samples, among which 21 (28 %) were females and 14 (18.7 %) were males. Followed by Granulomas pattern which found in 22 (29.3 %) samples, among which 14 (18.7 %) were females, and 8 (10.7 %) were males. Necrotizing, and Necrotizing with Suppurative were the least observed pattern with 11 (14.7 %) and 7 (9.3 %) respectively. Cervical lymph node 30 (40 %), was the most lymph node involved, followed by the Inguinal lymph node 19 (25.3 %), Supraclavicular and Axillary lymph nodes were the least observed with 14 (18.7) and 12 (16 %) respectively. On the basis of this study, fine needle aspiration cytology found to be an essential tool in trending towards making a firm diagnosis in tuberculous lymphadenitis. So we recommend that, fine needle aspiration cytology should be performed for any lymphadenopathy, as well as Z-N stain which will be of great value in cases of inflammatory conditions differentiation. In parallel of cytological and microbiological stains other techniques such as rapid molecular-based diagnostic tests, should be applied in order to improve the diagnostic sensitivity and specificity in this setting.