Evaluation for Granulomatous Inflammation on Fine Needle Aspiration Cytology Using Special Stains

Abstract

Background. Tuberculosis is the commonest infectious disease in the developing world. Many diagnostic tests are devised for its detection including direct smear examination. This study was designed to determine the frequency of cases positive for AFB and positive for fungus in patients diagnosed to have granulomatous inflammation on Fine Needle Aspiration Cytology using special stains. Materials and Methods. A descriptive cross-sectional survey was done on 100 cases of granulomatous inflammation consistent with tuberculosis diagnosed on fine needle aspiration cytology at the Department of Pathology, King Edward Medical University, Lahore. After reporting granulomatous inflammation on Hematoxylin & Eosin staining of aspirates from FNAC, some unstained slides were subjected to special stains, like ZN, GMS, and PAS. Cases positive for AFB on ZN stain and fungus on GMS/PAS were noted down along with their frequency and percentages. Results. Forty-four cases (44%) of AFB positive smears were reported in granulomatous inflammation while only 5% cases of fungus were reported down. Cervical lymph nodes were the most commonly involved site (87%), and females were affected more (62%) than males. Most cases of AFB-positive smears were associated with caseation necrosis (93%). Conclusion. Special stains should be done on all granulomatous inflammation cases seen on FNAC for confirmation of TB and ruling out other infectious causes.

Comparison of Ziehl-Neelsen Stains With Fine Needle Aspiration Technique in Diagnosis of Tuberculous Lymphadenitis in a Tertiary Care Hospital, South Bihar (India)

“…The finding that the majority of the patients (40; 40%) were from 11-30 years age group correlates with those of the other studies conducted by Bezabih and Mariam, [8] Lobo et al [15] Teklu et al, [16] Hart et al, [17] and Majeed and Bukhari. [18] Most common site involved was cervical region in 75 (75%) cases, which also correlates with the findings of other studies carried out by Bezabih et al, [8] Lau et al, [11] and Chen et al [19] Tuberculosis was the most common finding in 50 (50%) cases, followed by other inflammatory lymphadenitis in 50 (50%). ZN stain was found to be positive for AFB in 42 (42%) cases, which correlates with the findings of other studies conducted by Majeed and Bukhari, [18] Kheiry and Ahmed, [20] and Rajwanshi et al, [21] which reported ZN positivity of 37.4%, 59.4%, and 40% respectively.…”

“…[18] Most common site involved was cervical region in 75 (75%) cases, which also correlates with the findings of other studies carried out by Bezabih et al, [8] Lau et al, [11] and Chen et al [19] Tuberculosis was the most common finding in 50 (50%) cases, followed by other inflammatory lymphadenitis in 50 (50%). ZN stain was found to be positive for AFB in 42 (42%) cases, which correlates with the findings of other studies conducted by Majeed and Bukhari, [18] Kheiry and Ahmed, [20] and Rajwanshi et al, [21] which reported ZN positivity of 37.4%, 59.4%, and 40% respectively. Most common cytological pattern observed was epithelioid granuloma with caseous necrosis and with or without Langhans giant cells in 37 (37%) cases, which is similar to the study conducted by Gupta et al [19] Highest AFB positivity was seen in 119 (33.90%) cases with necrosis with or without granuloma and inflammatory cells.…”

Prevalence of tuberculous lymphadenitis in Gondar University Hospital, Northwest Ethiopia

“…Tuberculous that affects cervical lymph nodes represents about 50% of EPTB even though it could vary in different areas [12]. A number of studies showed higher proportion of tuberculous lymphadenitis among patients in different areas [13-16]. In a study conducted in the rural part of Ethiopia, 72.8% cases of TBLN were found [17] and the cervical region was the most affected site (74.2%) followed by the axillaries and inguinal lymph node regions, 20.3% and 4.3%, respectively [18].…”

Isolated cerebellar tuberculoma mimicking posterior cranial fossa tumour

“…Sarcoidosis is one of the most common non-infectious granulomatous diseases. Another group of diseases are Wegener's granulomatosis, foreign body reaction and Langerhans cell histiocytosis 5. Imaging features of tuberculomas are known to overlap with those of other intracranial focal lesions, like the healing stage of neurocysticercosis, fungal granulomas, chronic pyogenic brain abscess and lymphomas.…”