Utility of Fine Needle Aspiration Cytology in Bacille Calmette–Guerin Lymphadenitis: An Institutional Experience
Background: The Bacille Calmette–Guerin (BCG) vaccine is a live attenuated vaccine that is a part of the National Immunization Program in India. It protects infants and children from tubercular meningitis and disseminated tuberculosis. It is usually a safe vaccine but can cause mild and severe adver...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Jaypee Brothers Medical Publisher
2024-11-01
|
| Series: | Pediatric Infectious Disease |
| Subjects: | |
| Online Access: | https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1444 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849702928302997504 |
|---|---|
| author | Saba Naaz Sonam Sharma Amrutha Aravind Mukul Singh |
| author_facet | Saba Naaz Sonam Sharma Amrutha Aravind Mukul Singh |
| author_sort | Saba Naaz |
| collection | DOAJ |
| description | Background: The Bacille Calmette–Guerin (BCG) vaccine is a live attenuated vaccine that is a part of the National Immunization Program in India. It protects infants and children from tubercular meningitis and disseminated tuberculosis. It is usually a safe vaccine but can cause mild and severe adverse reactions including suppurative lymphadenitis as well as osteitis. BCG vaccine-induced regional lymphadenitis can be easily misdiagnosed and can lead to unnecessary therapeutic as well as surgical interventions. Fine needle aspiration cytology (FNAC) in such cases is a minimally invasive procedure for not only making an early and accurate diagnosis but can also have a curative role.
Aim: To study the utility of FNAC in BCG lymphadenitis and to create awareness regarding this entity.
Materials and methods: This study has been conducted for 3 years (December 2021 to December 2023). We analyzed 16 cases of BCG lymphadenitis diagnosed on FNAC. Their clinical presentation, cytomorphological features, and clinical outcomes were studied.
Results: Of all the 16 cases, 10 patients were males and 6 were females. The minimum age for the presentation was 5 months and the maximum was 2 years. The majority had left-sided axillary lymph node enlargement without any constitutional symptoms. FNAC yielded pus aspirates in 80% of cases. Cytological examination showed inflammatory cells (62.5%), reactive lymphoid cells (37.5%), and epithelioid cell granulomas with necrosis (18.7%), along with giant cells in 12.5% of cases. Ziehl–Neelsen staining for acid-fast bacilli was positive in 13 cases. On follow-up, lymphadenitis regressed in most of them within a few months of diagnosis.
Conclusion: Bacille Calmette–Guerin lymphadenitis is a benign condition that remits spontaneously within a few weeks without any treatment in most cases. A high index of suspicion, clinical history, and FNAC play an important role in its detection and management. |
| format | Article |
| id | doaj-art-792da0c358524c8cbc7770d73b901027 |
| institution | DOAJ |
| issn | 2582-4988 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Jaypee Brothers Medical Publisher |
| record_format | Article |
| series | Pediatric Infectious Disease |
| spelling | doaj-art-792da0c358524c8cbc7770d73b9010272025-08-20T03:17:27ZengJaypee Brothers Medical PublisherPediatric Infectious Disease2582-49882024-11-016412012310.5005/jp-journals-10081-14443Utility of Fine Needle Aspiration Cytology in Bacille Calmette–Guerin Lymphadenitis: An Institutional ExperienceSaba Naaz0Sonam Sharma1Amrutha Aravind2Mukul Singh3Department of Pathology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, IndiaSonam Sharma, Department of Pathology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India, Phone: +91 9991743193Department of Pathology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, IndiaDepartment of Pathology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, IndiaBackground: The Bacille Calmette–Guerin (BCG) vaccine is a live attenuated vaccine that is a part of the National Immunization Program in India. It protects infants and children from tubercular meningitis and disseminated tuberculosis. It is usually a safe vaccine but can cause mild and severe adverse reactions including suppurative lymphadenitis as well as osteitis. BCG vaccine-induced regional lymphadenitis can be easily misdiagnosed and can lead to unnecessary therapeutic as well as surgical interventions. Fine needle aspiration cytology (FNAC) in such cases is a minimally invasive procedure for not only making an early and accurate diagnosis but can also have a curative role. Aim: To study the utility of FNAC in BCG lymphadenitis and to create awareness regarding this entity. Materials and methods: This study has been conducted for 3 years (December 2021 to December 2023). We analyzed 16 cases of BCG lymphadenitis diagnosed on FNAC. Their clinical presentation, cytomorphological features, and clinical outcomes were studied. Results: Of all the 16 cases, 10 patients were males and 6 were females. The minimum age for the presentation was 5 months and the maximum was 2 years. The majority had left-sided axillary lymph node enlargement without any constitutional symptoms. FNAC yielded pus aspirates in 80% of cases. Cytological examination showed inflammatory cells (62.5%), reactive lymphoid cells (37.5%), and epithelioid cell granulomas with necrosis (18.7%), along with giant cells in 12.5% of cases. Ziehl–Neelsen staining for acid-fast bacilli was positive in 13 cases. On follow-up, lymphadenitis regressed in most of them within a few months of diagnosis. Conclusion: Bacille Calmette–Guerin lymphadenitis is a benign condition that remits spontaneously within a few weeks without any treatment in most cases. A high index of suspicion, clinical history, and FNAC play an important role in its detection and management.https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1444bacille calmette–guerin vaccinecytologylymphadenitis<italic>mycobacterium bovis</italic> |
| spellingShingle | Saba Naaz Sonam Sharma Amrutha Aravind Mukul Singh Utility of Fine Needle Aspiration Cytology in Bacille Calmette–Guerin Lymphadenitis: An Institutional Experience Pediatric Infectious Disease bacille calmette–guerin vaccine cytology lymphadenitis <italic>mycobacterium bovis</italic> |
| title | Utility of Fine Needle Aspiration Cytology in Bacille Calmette–Guerin Lymphadenitis: An Institutional Experience |
| title_full | Utility of Fine Needle Aspiration Cytology in Bacille Calmette–Guerin Lymphadenitis: An Institutional Experience |
| title_fullStr | Utility of Fine Needle Aspiration Cytology in Bacille Calmette–Guerin Lymphadenitis: An Institutional Experience |
| title_full_unstemmed | Utility of Fine Needle Aspiration Cytology in Bacille Calmette–Guerin Lymphadenitis: An Institutional Experience |
| title_short | Utility of Fine Needle Aspiration Cytology in Bacille Calmette–Guerin Lymphadenitis: An Institutional Experience |
| title_sort | utility of fine needle aspiration cytology in bacille calmette guerin lymphadenitis an institutional experience |
| topic | bacille calmette–guerin vaccine cytology lymphadenitis <italic>mycobacterium bovis</italic> |
| url | https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1444 |
| work_keys_str_mv | AT sabanaaz utilityoffineneedleaspirationcytologyinbacillecalmetteguerinlymphadenitisaninstitutionalexperience AT sonamsharma utilityoffineneedleaspirationcytologyinbacillecalmetteguerinlymphadenitisaninstitutionalexperience AT amruthaaravind utilityoffineneedleaspirationcytologyinbacillecalmetteguerinlymphadenitisaninstitutionalexperience AT mukulsingh utilityoffineneedleaspirationcytologyinbacillecalmetteguerinlymphadenitisaninstitutionalexperience |