scholarly journals Cytomorphological Spectrums in Tuberculous Lymphadenitis: Understanding the Stages of Disease

2018 ◽  
Vol 1 (2) ◽  
pp. 21-29
Author(s):  
Anju Pradhan ◽  
P. Poudyal ◽  
P. Upadhyaya ◽  
S. Pokhrel
Keyword(s):  
Lymph Nodes ◽  
Chronic Renal Disease ◽  
Extrapulmonary Tuberculosis ◽  
Previous History ◽  
Diagnostic Technique ◽  
Neck Region ◽  
Needle Aspiration ◽  
Tuberculous Lymphadenitis ◽  
Granulomatous Lymphadenitis ◽  
Needle Aspiration Cytology

Introduction: Tuberculous lymphadenitis is the most common form of extrapulmonary tuberculosis and one of the main causes of lymphadenopathy. Fine Needle Aspiration Cytology (FNAC) has played a substantial role in diagnosis of tuberculous lymphadenopathy and it has become a first-line diagnostic technique. The aim of this study was to describe and understand the spectrum of cytomorphological changes seen in tuberculous lymphadenitis corresponding to stages of disease and to associate the cytomorphological changes with Acid Fast Bacilli (AFB) positivity. Methods: This is a retrospective cytomorphological study of cytologically diagnosed tuberculous lymphadenitis. The recorded details of clinical presentation and site of the lymph nodes were noted. The slides were stained with Papanicolaou, Giemsa and AFB. Result: There were a total of 203 cases with age ranging from 3- 75 years. Four cytomorphological patterns observed were Necrotising Granulomatous Lymphadenitis (NGL; 45.32%), Granulomatous Lymphadenitis (GL, 18.22%), Necrotising Suppurative Lymphadenitis (NSL; 21.18%) and Necrotising Lymphadenitis (NL; 15.27%). Necrotising patterns were observed in immunocompromised individuals like HIV infected patients, in patients with previous history of tuberculosis and in patients with chronic renal disease. Strong AFB positivity was observed in necrotising patterns. Lymph nodes of head and neck region were the most common site of involvement with cervical being the commonest. Conclusion: Necrotizing patterns are observed in the later stages of disease or in the immunocompromised patients. Strong positivity for AFB is observed in the smears with necrotizing patterns and less in the granulomatous pattern.

Cytopathology Lymphadenopathy Feature in HIV Positve Patient: Diagnosis Tools Comorbidities

2016 ◽  
Vol 1 (3) ◽  
Author(s):  
Hasrayati Agustina ◽  
Yenni Wisudarma ◽  
Ris Kristiana ◽  
Bethy S. Hernowo
Keyword(s):  
Lymph Nodes ◽  
Medical Records ◽  
Fine Needle Aspiration Biopsy ◽  
Clinical Manifestations ◽  
Needle Aspiration ◽  
Hiv Positive ◽  
Tuberculous Lymphadenitis ◽  
Patient Diagnosis ◽  
Granulomatous Lymphadenitis ◽  
Anatomical Pathology

Lymphadenopathy is enlarged lymph nodes caused by infection, inflammation or malignancy. On HIV positive patients, lymphadenopathy is one of the most common clinical manifestations and it is usually persistent. Fine-needle aspiration biopsy (FNAB) is an effective cytology technique in determining the diagnosis of lymphadenopathy. This study aimed to describe the cytopathology of lymphadenopathy in HIV positive patients. This is a descriptive study of 21 cases of lymphadenopathy in patients with HIV positive who underwent FNAB examination in Anatomical Pathology Department of Dr.Hasan Sadikin Hospital between 2013-2014. Medical data was taken from the patient medical records including age, sex, location, size and cytopathological diagnosis. Cytopathology overview of FNAB specimens were reassessed by 2 pathologists. In this study, lymphadenopathy in HIV positive patients were mainly found in men (n = 15.71%) with an average age between 20-30 years. The most frequent location was the neck (n = 20.95.2%). The lymph nodes size were found between 0.5-3 cm. Most diagnosis was tuberculous lymphadenitis (n = 15.71%) with the most common cytology feature was granulomatous lymphadenitis (n = 5.33.3%) and suppurative lymphadenitis (n = 5.33.3%). FNAB examination in lymphadenopathy is very helpful to identify the cause of infection in HIV positive patients. Keywords: FNAB, HIV, lymphadenopathy, cytopathology

scholarly journals Clinical profile of cervical lymphadenopathy and to find diagnostic efficacy of fine-needle aspiration cytology, ultrasonography and histopathological examination

2020 ◽  
Vol 6 (3) ◽  
pp. 551
Author(s):  
Nitin Sharma ◽  
Maya Singh ◽  
Pritosh Sharma ◽  
Rahul Nahar ◽  
V. P. Goyal
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Cervical Lymphadenopathy ◽  
Needle Aspiration ◽  
Tuberculous Lymphadenitis ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Common Diagnosis ◽  
Granulomatous Lymphadenitis ◽  
Needle Aspiration Cytology

<p class="abstract"><strong>Background:</strong> Cervical lymphadenopathy is the sign of a disease process which involves lymph nodes that are anomalous in uniformity and dimensions. It is very vital to exercise fine-needle aspiration biopsy, histopathological investigation, and ultrasonography for the diagnosis of palpable lesions.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 12-month duration from January 2018 to December 2018 in 61 patients presenting with cervical lymphadenopathy admitted in the ENT Department at Geetanjali Medical College and Hospital, Udaipur.  </p><p class="abstract"><strong>Results:</strong> In biopsy, most common diagnosis was chronic granulomatous lymphadenitis i.e. in 62.3% of the patients. As compared to biopsy, fine-needle aspiration cytology (FNAC) showed chronic granulomatous lymphadenitis in 46% of the patients, with overall sensitivity of 91.1%, and specificity of 60.0%. and accuracy of 88.5%. Whereas ultrasonography (USG) reported, 64% cervical lymphadenopathy in patients, with overall sensitivity came out to be 91.1%, specificity to be 40.0%, accuracy was 86.9%.</p><p class="abstract"><strong>Conclusions:</strong> Present study showed that biopsy is the gold standard procedure for diagnosis of cervical lymphadenopathy lesions followed by FNAC, USG. Tuberculous lymphadenitis was most common diagnosis made by the diagnostic modalities.</p>

scholarly journals Tuberculosis Infection Mimicking Brain Metastatic Malignancy Lesions in an Elderly Male

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Dimitrios Anyfantakis ◽  
Ageliki Damianaki ◽  
Maria Kokosi ◽  
Emmanouil K. Symvoulakis ◽  
Serafim Kastanakis
Keyword(s):  
Medical Condition ◽  
Extrapulmonary Tuberculosis ◽  
Needle Aspiration ◽  
Axillary Lymph ◽  
Elderly Male ◽  
Perivascular Edema ◽  
Metastatic Lesions ◽  
Granulomatous Lymphadenitis ◽  
Nodular Lesions ◽  
Needle Aspiration Cytology

An 83-year-old Caucasian Greek man was referred by his general practitioner to the emergency department of the general hospital in Crete because of seizures and agitation. His past medical history was negative for any neurological or medical condition. Electroencephalogram showed a bradyarrhythmic theta activity, without evidence of any focal or other specific abnormality. Magnetic resonance imaging of the brain demonstrated a number of diffuse nodular lesions and moderate perivascular edema. An axillary lymph node fine needle aspiration cytology suggested a granulomatous lymphadenitis along with signs of tuberculous infiltration. Tuberculin skin test was positive. We report a rare case of extrapulmonary tuberculosis mimicking brain metastatic lesions.

scholarly journals Correlation between cytomorphology and acid fast bacilli positivity in tubercular lymphadenopathy in far Western Nepal: a hospital based study

2020 ◽  
Vol 8 (8) ◽  
pp. 2933
Author(s):  
Ashok Shreepaili ◽  
Sushil Dhakal
Keyword(s):  
Lymph Nodes ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Tuberculous Lymphadenitis ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Caseous Necrosis ◽  
Needle Aspiration Cytology ◽  
Tubercular Lymphadenitis

Background: Tuberculous lymphadenitis is the most common manifestation of extrapulmonary tuberculosis. Fine needle aspiration cytology (FNAC) is a valuable tool in diagnosis of tubercular lymphadenitis. The present study aims to determine the prevalence of different cytomorphological patterns in fine needle aspiration cytology of tubercular lymph nodes and their correlation with Acid Fast Bacilli (AFB) positivity on Ziehi-Neelsen (ZN) Staining.Methods: Fine needle aspiration cytology of 274 cases diagnosed as tubercular lymphadenitis over a period of a year were reviewed. Cytomorphological patterns were categorized into three patterns. Pattern I: Epithelioid granuloma without necrosis, Pattern II: Epithelioid granuloma with caseous necrosis and Pattern III: Caseous necrosis only. Fischer Exact test was applied to correlate cytomorphological pattern and AFB positivity.Results: Tuberculous lymphadenitis was most frequent in age group 21-30 years (24.81%). Cervical lymph nodes were the most frequent lymph nodes involved (84.67%). Pattern I was the most common cytomorphological pattern observed (49.3%). Overall AFB positivity was 28.10%. Maximum AFB positivity was seen in pattern III (73.3%).Conclusions: FNAC is the simple, cost effective and minimally invasive tool to diagnose tuberculous lymphadenitis. Study of both cytomorphological pattern and ZN staining for AFB can improve the diagnostic accuracy.

scholarly journals Diagnosis of tubercular lymphadenopathy by fine needle aspiration cytology and Z-N staining

2019 ◽  
Vol 7 (8) ◽  
pp. 2985
Author(s):  
Navneet Naz ◽  
Megha Sharma
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Diagnostic Technique ◽  
Needle Aspiration ◽  
Vital Role ◽  
Cervical Region ◽  
Medical College ◽  
Caseous Necrosis ◽  
Needle Aspiration Cytology ◽  
Minimal Invasion ◽  
Tubercular Lymphadenitis

Background: Tuberculosis continues to be the biggest health problem in India. Tuberculosis involves respiratory, gastrointestinal tract as well as extrapulmonary site. Tubercular lymphadenopathy is the most common form of extrapulmonary tuberculosis. FNAC plays a vital role in diagnosis of tubercular lymphadenopathy. FNAC is not only used for cytological diagnosis but also used for other ancillary tests like Ziehl-Neelsen staining and AFB culture.Methods: The study was conducted in the department of pathology, Government Medical College, Jammu over a period of 6 months and included 450 cases presenting with superficial lymphadenopathy. FNAC was performed in the cases and smears in each case, were stained with May Grunwald Giemsa (MGG), Papanicolaou and Z-N stain.Results: Out of 450 cases,160 cases (35.5%) showed features of tubercular lymphadenitis. The most common site of presentation, being cervical region with 75% cases. Females outnumbered males by ratio of 1.46:1. In cytomorphology 93 cases (58.1%) showed epithelioid granulomas with caseous necrosis,37 cases (23.1%) showed caseous necrosis only while only epithelioid granulomas were seen in 30 cases (23.1%). AFB positivity was seen in 82 cases with maximum AFB positivity (78.3%) seen in cases with necrosis only.Conclusions: FNAC is a rapid diagnostic technique because of its simplicity, cost effectiveness, early availability of results and minimal invasion. FNAC is a reliable and sensitive first line investigation in diagnosis of tubercular lymphadenitis combined with AFB staining.

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

2019 ◽  
Vol 9 (1) ◽  
pp. 30-33
Author(s):  
Tamanna E Nur ◽  
Afroz Shirin ◽  
Moni Mohan Saha
Keyword(s):  
Lymph Nodes ◽  
Diagnostic Accuracy ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Tuberculous Lymphadenitis ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Background: Tuberculosis is still a global health problem. Most common presentation of extrapulmonary tuberculosis is tuberculous lymphadenitis. In our setting, keeping huge burden of tuberculosis in mind, clinicians have to depend 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. Objective: To determine the diagnostic accuracy of fine needle aspiration cytology in providing a diagnosis of tuberculous lymphadenitis patients in Bangladesh. Materials and Methods: This cross-sectional study was done on 317 subjects in Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration with icddr,b. After clinical examination, fine needle aspiration (FNA) was done. The FNA materials were processed for Papanicoulaou staining (PAP stain), Ziehl-Neelsen staining and culture for the diagnosis of tuberculosis. Sensitivity, specificity, positive and negative predictive values of FNAC were determined where culture was taken as the gold standard. Results: Initially 351 clinically suspected tuberculous lymphadenitis patients were enrolled, but 34 cases were excluded due to diagnosis of malignancy. Among them 123 were male and 194 were female. Mean age was 27.91±13.16 years. Among the subjects 95.9% presented with cervical lymphadenopathy, others presented with lymphadenopathy of axillary or other groups of lymph nodes. The results of cytomorphological diagnosis of TB were in 58.36% cases, and culture was positive in 23.3% cases. Sensitivity, specificity, positive predictive value and negative predictive value of cytomorphological diagnosis were 79.7%, 48.1%, 31.9% and 88.6% respectively. Conclusions: FNAC is an effective diagnostic method for tuberculous lymphadenitis. It can diagnose granulomatous inflammation as well as reactive and other disease conditions including malignancies, thereby providing more information about the patient’s disease status. J Enam Med Col 2019; 9(1): 30-33

Fine-Needle Aspiration Cytology in Diagnosis of Tuberculous Lymphadenitis: Experience From a Tertiary Hospital in Tanzania

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S95-S96
Author(s):  
Caroline Ngimba ◽  
Amos Mwakigonja
Keyword(s):  
Lymph Nodes ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Tertiary Hospital ◽  
Response To Treatment ◽  
Tuberculous Lymphadenitis ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Abstract Objectives Tuberculous lymphadenitis is among the common causes of lymphadenopathy in low-resource countries. Data regarding diagnosis of tuberculous lymphadenitis based on fine-needle aspiration cytology of the lymph nodes are scant in our setting. The current study was conducted to determine the usefulness of fine-needle aspiration materials in the diagnosis of Tb lymphadenitis among patients who presented with enlarged lymph nodes. Methods A prospective study was conducted at Muhimbili National Hospital for the duration of 1 year (April 2016 to March 2017). Patients with enlarged lymph nodes were subjected to fine-needle aspiration cytology and smears were stained with Papanicolaou stain as well as Ziehl Nielsen (ZN). Criteria for diagnosing TB on cytology included granulomas, caseous necrosis, and epithelioid cells. All aspirates were subjected to GeneXpert assay for Mycobacterium tuberculosis. All cases diagnosed with TB based on cytological materials were initiated anti-TB. Follow-up of patients was done and response to treatment was used to confirm the diagnosis. Results One hundred sixteen cases were studied. Out of 116 cases of lymph nodes aspirated, 58 cases (50%) were diagnosed as tuberculous lymphadenitis. Females represented the majority of the cases, 31/58 (53%), and the most affected age group was 18 to 35 years. Cytomorphology of TB was found in 40/58 cases (68%) and ZN positivity for acid-fast bacilli (AFB) was found in 14/58 (24%) while Gene Xpert assay was positive in 29/58 (50%) of cases. The response to treatment was 100%. Conclusion Fine-needle aspiration cytology (FNAC) has shown to be simple, safe, and with higher accuracy in diagnosis of tuberculous lymphadenitis based on evaluation of cytomorphology with complementation of ZN stain for AFB in TB endemic areas. The diagnostic accuracy can be further increased by GeneXpert analysis, which can test the drug resistance of the Mycobacterium.

“CYTOMORPHOLOGICAL PATTERNS OF TUBERCULOUS LYMPHADENITIS AND ITS CORRELATION WITH ZIEHL-NEELSEN STAINING AND CBNAAT IN A TERTIARY CARE CENTRE OF HARYANA”

2021 ◽  
pp. 73-75
Author(s):  
Singh S ◽  
Arora S ◽  
Munesh Munesh ◽  
Mahajan S
Keyword(s):  
Developing Countries ◽  
Tertiary Care ◽  
Diagnostic Technique ◽  
Needle Aspiration ◽  
Tuberculous Lymphadenitis ◽  
Tertiary Care Centre ◽  
Adequate Treatment ◽  
Caseous Necrosis ◽  
Cytological Features ◽  
Needle Aspiration Cytology

Introducion: Tuberculosis (TB) is still prevalent in developing countries, and one of the most common cause of tuberculous lymphadenopathy. Quick diagnosis is necessary for adequate treatment. Fine needle aspiration cytology (FNAC) is an efcient and rapid primary diagnostic technique as an alternative to excision. Cytomorphologic features of well-formed epithelioid granulomas and the presence of caseous necrosis are sufcient for cytological diagnosis. Mycobacteriological conrmation however, is essential to rule out other causes of granulomatous inammation. Material and methods: This study was aimed at evaluating and correlating the role of FNAC, mycobacterium recognition by Ziehl-Neelsen staining (ZN staining) with Cartridge based nucleic acid amplication test (CBNAAT) positivity to diagnose tuberculous lymphadenitis. FNA material was collected from 97 patients and was analysed by cytomorphology, ZN stain and CBNAAT. Result: Out of 97 cases, 66 cases had cytological features consistent with TB. 40.9% of the smears showed epithelioid granulomas with caseous necrosis, followed by 31.8% smears showing epithelioid granuloma without necrosis and necrosis with polymorphs without granuloma in 27.3% of the smears. Amongst the 27 cases showing granuloma with necrosis, there was 44.4% AFB positivity and 48.1% CBNAAT positivity while 21 cases of granuloma without necrosis showed 52.3% AFB positivity and 47.6% CBNAAT positivity. In the 18 cases showing necrosis there was 72.2% AFB positivity and 83.3% CBNAATpositivity. Conclusion: The presence of caseous necrosis and granulomas are strongly suggestive of tubercular etiology, especially in developing countries with high incidence of TB. AFB smear CBNAATcan supplement cytomorphometry for rapid and accurate diagnosis.

Evaluation of cervical lymph nodes by ultrasound and its correlation with FNAC

2021 ◽  
Vol 12 (2) ◽  
pp. 65-68
Author(s):  
Kalyan Sekhar Popuru ◽  
Keyword(s):  
Lymph Nodes ◽  
Ultrasound Examination ◽  
Cervical Lymphadenopathy ◽  
Diagnostic Technique ◽  
Neck Region ◽  
Needle Aspiration ◽  
Medical Sciences ◽  
Cervical Lymph Nodes ◽  
Female Ratio ◽  
A Prospective Study

Background: The cervical/neck region has a rich network of strategically placed lymph nodes. These nodes can be involved in various diseases. Ultrasound examination of these nodes can yield useful information about the underlying pathologic processes. Aim of The Study: Evaluation of cervical lymph nodes by ultrasound and its correlation with FNAC. Materials and Methods: This was a prospective study done in the department of Radiodiagnosis at Mamata Academy of Medical Sciences, Bachupally, Hyderabad, Telangana, over a period of eight months. A total of 110 cases were studied. First ultrasound examination of the neck nodes was done followed by fine needle aspiration study. The borders of the nodes, echotexture, capsular and hilar vascularity were noted. The findings of the two modalities were correlated. Results: A total of 110 cases were studied with age ranging from 10 years to 70 years. The male to female ratio was 0.2:1. Most (77.2%) cases were diagnosed as reactive lymph nodes on ultrasound. Most of the reactive lymph nodes (70/85) had homogenous echotexture. Most of the reactive lymph nodes (65/85) had hilar vascularity whereas most of the malignant nodes (8/10) showed absence of hilar vascularity. There was good correlation between the ultrasound and FNAC diagnosis of cervical lymph nodes. Conclusion: Cervical lymphadenopathy is more common in the third to fifth decades of life. Reactive enlargement is more common than other etiologies. USG of cervical lymph nodes is a simple, noninvasive diagnostic technique useful for initial evaluation of the nodes and gives clues towards the possible etiology of the lymphadenopathy. For suspicious cases, an FNAC can be done and if the results are equivocal then biopsy procedure can be done for definite diagnosis.

scholarly journals Evaluation of non-palpable axillary lymph nodes metastasis with ultrasonography guided fine needle aspiration cytology in carcinoma breast and comparing with histopathological report

2021 ◽  
Vol 8 (8) ◽  
pp. 2392
Author(s):  
Sanchit Bansal ◽  
Rachhpal Singh ◽  
Arun K. Gupta
Keyword(s):  
Lymph Nodes ◽  
Axillary Dissection ◽  
Diagnostic Technique ◽  
Needle Aspiration ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Carcinoma Breast ◽  
Needle Aspiration Cytology

Background: Breast malignancies are the second most common cause of cancer related mortality among women. As the size of the primary breast cancer increases, some cancer cells are shed into cellular spaces and transported via the lymphatic network of the breast to the regional lymph nodes, especially the axillary lymph nodes. Objective of the study is to evaluate the diagnostic accuracy of axillary ultrasound (US) guided fine-needle-aspiration cytology (FNAC) in patients with breast carcinoma, in comparison with the final histological examination (sentinel node biopsy and/or axillary dissection). Methods: This prospective study will be conducted on 40 consecutive patients with biopsy proven breast cancer with clinically negative axilla, who had attending the OPD or IPD in our department of surgery, SGRD hospital Amritsar. All of these patients are planned to undergo surgery (breast conservation or modified radical mastectomy with axillary clearance).Results: Patients detected with LN metastasis on FNAC can directly undergo axillary dissection without the need of any other diagnostic technique like SLNB in non-palpable axillary lymph nodes.Conclusions: Thus, we can conclude that ultrasonography (USG) guided FNAC due to its moderate sensitivity, high specificity and PPV in relation to histopathological examination (HPE) is a good diagnostic technique for diagnosing patients with axillary lymph node metastasis in case of clinically non palpable axillary lymph nodes in carcinoma breast patients.

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