Diagnostic Accuracy of Fine Needle Aspiration Cytology in Diagnosis of Tuberculous Lymphadenitis

Nur, Tamanna E; Shirin, Afroz; Saha, Moni Mohan

doi:10.3329/jemc.v9i1.39901

Cited by 6 publications

(7 citation statements)

References 9 publications

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“…Whereas, females are most commonly affected by tubercular lymphadenopathy; the proportion of male to female was 1: 1.93. Our study was shown similar result by some previously published studies by Farooq et al [13] ; Nur et al [14] ; Badge et al [16] and Bhatta et al [17] . In our study, tubercular lymphadenopathy cases are most commonly seen in the age range of 21-30 years accounting 34.11% followed by the age range of 11-20 years accounting to 29.61%, cases.…”

Section: Discussionsupporting

confidence: 93%

“…In our study, tubercular lymphadenopathy cases are most commonly seen in the age range of 21-30 years accounting 34.11% followed by the age range of 11-20 years accounting to 29.61%, cases. Correlate to the past studies that observed by some previous studies, given by Agarwal et al [8] ; Nur et al [14] ; Badge et al [16] and Mainali et al [18] .…”

Section: Discussionsupporting

confidence: 89%

“…93.73% [11] and 72.5% cases of cervical in which FNAC was performed given by Ikram et al [12] . The cervical lymph node was the most frequently affected group of lymph nodes accounting to 74.24% similar observations also given by Patro et al [9] ; Farooq et al [13] and Nur et al [14] .…”

Section: Discussionsupporting

confidence: 85%

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Utility of FNAC as a Diagnostic Role in Lymphadenopathy Cases of Different Age Groups

Tiwari¹,

Singh²

2019

SSR-IIJLS

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Background: Fine-needle aspiration cytology (FNAC) is a simple diagnostic tool to diagnose causes of lymphadenopathy. The cytologic patterns of lymph node fine needle aspirations (FNAs) show signs of a wide variation in different diseases. In the present study, we study the cytologic patterns of lymph node sequence of different age groups. Methods: The present study was conducted in the Department of Pathology, GSVM Medical College, Kanpur. The total number of cases 1681 with lymphadenopathy was taken for this study. Routine investigations, which included complete blood counts, biochemical tests, X-Ray chest (PA View), Ultrasound/ CT scan (If indicated). FNAC was done and the slides were stained with Haematoxylin and Eosin stain, Giemsa stain and Ziehl-Neelsen stain (if indicated). Results: In the present study, the commonest site of involvement was the cervical lymph node 1196 (71.15%). Overall benign lesions were 1575 (93.69%) and malignant lesions 106 (6.31%). In benign lesions, Tubercular lymphadenitis was the most frequently encountered lesion 934 (55.56%) followed by reactive hyperplasia 310 (18.44%). FNAC is a simple procedure and no hospitalization or anaesthesia is required. Conclusion: FNAC is a safe, inexpensive repeatable and rapid procedure in which no anaesthesia is required. FNAC is useful as an outdoor diagnostic procedure because of early diagnosis in comparison to histopathological diagnosis.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 89%

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Utility of FNAC as a Diagnostic Role in Lymphadenopathy Cases of Different Age Groups

Tiwari¹,

Singh²

2019

SSR-IIJLS

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“…Fine-needle aspiration (FNA) cytology is minimally invasive and costeffective. It is an outpatient diagnostic procedure, nevertheless, the sensitivity and specificity are variable, in the diagnosis of tubercular lymphadenopathy (4). The Ziehl-Neelsen (ZN) staining technique for acidfast bacilli (AFB) is a simple, cheap, and rapid method.…”

Section: Introductionmentioning

confidence: 99%

A Clinicopathological Study of Fine Needle Aspirates of Lymph Nodes from Patients with Suspected Tubercular Lymphadenopathy: Analysis of 640 Cases from a Tertiary Health Care Centre in North India

Ahmed

Ansari

Fatima

2022

Int J Health Sci Res

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Introduction: Fine needle aspiration cytology (FNAC) of lymph nodes is an out-patient, simple and, quick, cost-effective procedure that helps in the diagnosis of tubercular lymphadenopathy. This technique has high sensitivity and specificity which in addition to the establishment of cytological diagnosis, also helps to perform ancillary tests like ZN staining for AFB Bacilli and GeneXpert MTB/RIF Assay. Aims: To study the clinical and cytopathological features of fine-needle aspirates of lymph nodes from patients with suspected tubercular lymphadenopathy along with the role of ZN staining And GeneXpert assay in diagnosis. Materials and Methods: In this study 1123 patients presenting with lymphadenitis presenting to the cytopathology lab for FNAC of lymph nodes between May 2018 to May 2021 were included. Out of 1123 patients presenting with lymphadenopathies, there were 640 cases of tuberculous lymphadenitis. The clinical and cytopathological findings of these 640 cases were analyzed. Results: Most cases of tubercular lymphadenopathy were of the adult age group (20-59 years) and showed a female predominance. The most commonly involved lymph node was the cervical group. The most common clinical feature observed was cough (68.5%). Among the four cytomorphological patterns observed, maximum cases showed epithelioid cell granuloma with necrosis. Ziehl- Neelsen staining showed overall AFB positivity of 40.3%. Smear showing necrosis without epithelioid cell granuloma showed maximum AFB positivity among the four patterns.GeneXpert MTB/RIF Assay showed an overall detection rate of 84%. Conclusion: FNAC is a simple, cost-effective, outpatient technique with high diagnostic accuracy in cases of tubercular lymphadenopathy which can be coupled by Ziehl Staining for Acid-fast bacilli and GeneXpert MTB/RIF Assay. However, in smear-negative cases, it poses a diagnostic dilemma, thus in a developing country like India with a high prevalence rate of tuberculosis, FNAC coupled with Z.N. staining and new molecular tests like GeneXpert MTB/RIF assay should be included in the first-line investigation in cases with tubercular lymphadenopathy. Key words: Tuberculosis, Fine Needle Aspirate Cytology(FNAC), Necrosis, Epithelioid cells, Cytopathological pattern, Ziehl–Neelsen Staining, GeneXpert Mycobacterium/Rifampicin(MTB/RIF) Assay

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“…Tamana E-Nur also reported the same pattern of FNAC having a higher sensitivity and lower specificity. The finding from Tamana E-Nur showed the sensitivity of 79.7% and specificity of 48.1% [ 25 ]. This seems to be lower than the finding from this study.…”

Section: Discussionmentioning

confidence: 99%

Integration of cytopathology with molecular tests to improve the lab diagnosis for TBLN suspected patients

et al. 2022

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Background Tuberculosis lymphadenitis (TBLN) diagnosis is often challenging in most resource poor settings. Often cytopathologic diagnosis of TBLN suspected patients is inconclusive impeding timely clinical management of TBLN suspected patients, further exposing suspected patients either for unnecessary use of antibiotics or empirical treatment. This may lead to inappropriate treatment outcome or more suffering of suspected patients from the disease. In this study, an integrated diagnostic approach has been evaluated to elucidate its utility in the identification of TBLN suspected patients. Methods A cross-sectional study was conducted on 96 clinically diagnosed TBLN suspected patients, where fine needle aspirate (FNA) samples were collected at the time of diagnosis. FNA cytology, Ziehl-Neelsen (ZN), Auramine O (AO) staining, GeneXpert MTB/RIF and Real time PCR (RT-PCR) were performed on concentrated FNA samples. Considering culture as a gold standard, the sensitivity, specificity, positive and negative predictive values were calculated. Cohen’s Kappa value was used to measure interrater variability and level of agreement and a P-value of <0.05 was considered as statistically significant. Result Out of the 96 FNA sample, 12 (12.5%) were identified to have Mycobacterium tuberculosis (Mtb) using ZN staining, 27 (28.1%) using AO staining, 51 (53.2%) using FNAC, 43 (44.7%) using GeneXpert MTB/RIF, 51 (53.1%) using Real time PCR (RT-PCR) and 36 (37.5%) using Lowenstein-Jensen (LJ) culture. Compared to LJ culture, the sensitivities of GeneXpert MTB/RIF, RT-PCR, and FNAC were 91.7%, 97.2%, and 97.2%, respectively and the specificities were 83.3%, 73.3%, and 68.3%, respectively. GeneXpert MTB/RIF and RT-PCR when combined with FNAC detected 61 (63.5%) cases as having Mtb, and the sensitivity and specificity was 100% and 58.3%, respectively. Conclusion FNA cytology and RT-PCR detected more TBLN cases compared to other Mtb detection tools and the detection sensitivity even improved when FNA cytology was combined with GeneXpert MTB/RIF, performed on concentrated FNA sample, suggesting the combined tests as an alternative approach for improved diagnosis of TBLN.

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Diagnostic Accuracy of Fine Needle Aspiration Cytology in Diagnosis of Tuberculous Lymphadenitis

Cited by 6 publications

References 9 publications

Utility of FNAC as a Diagnostic Role in Lymphadenopathy Cases of Different Age Groups

Utility of FNAC as a Diagnostic Role in Lymphadenopathy Cases of Different Age Groups

A Clinicopathological Study of Fine Needle Aspirates of Lymph Nodes from Patients with Suspected Tubercular Lymphadenopathy: Analysis of 640 Cases from a Tertiary Health Care Centre in North India

Integration of cytopathology with molecular tests to improve the lab diagnosis for TBLN suspected patients

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