An examination of the cytomorphological trends in tuberculous lymphadenitis at a tertiary care hospital of southern Assam

Introduction: Tuberculous lymphadenitis is a leading cause of lymph node enlargement accounting for 195 per 1,00,000 population in India. Fine needle aspiration cytology (FNAC) is rapid and economical compared to other tests and thus plays a crucial role in diagnosing this condition. It prevents unn...

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Main Authors: Sukanya Choudhury, Payel Hazari, Nicky Choudhury, Shah Alam Sheikh
Format: Article
Language:English
Published: Zabansaraye Parsian Novin Mehr Institute 2025-03-01
Series:Journal of Current Oncology and Medical Sciences
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Online Access:https://submission.journalofcoms.com/index.php/JCOMS/article/view/297
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author Sukanya Choudhury
Payel Hazari
Nicky Choudhury
Shah Alam Sheikh
author_facet Sukanya Choudhury
Payel Hazari
Nicky Choudhury
Shah Alam Sheikh
author_sort Sukanya Choudhury
collection DOAJ
description Introduction: Tuberculous lymphadenitis is a leading cause of lymph node enlargement accounting for 195 per 1,00,000 population in India. Fine needle aspiration cytology (FNAC) is rapid and economical compared to other tests and thus plays a crucial role in diagnosing this condition. It prevents unnecessary biopsy of lymph nodes and it can be used for collection of material for cytomorphological and bacteriological examination. This study aimed to assess the cytomorphological patterns of tuberculous lymphadenitis and correlate them with Ziehl-Neelsen (ZN) staining. Primary aim is to assess the cytomorphological patterns of tubercular lymphadenitis and to correlate with the bacteriological results using ZN staining. Materials and methods: The FNAC results of 100 cases diagnosed with tuberculous lymphadenitis over a period of one year were analyzed from the cytopathology section of Silchar Medical College and Hospital. The findings were classified into three patterns: pattern A - epithelioid granuloma in absence of caseous necrosis, pattern B - epithelioid granuloma with caseous necrosis, and pattern C - caseous necrosis in absence of epithelioid granuloma. The cytomorphological patterns were then correlated with acid-fast bacilli (AFB) positivity. Results: In individuals between the ages of 21 and 30, tuberculous lymphadenitis was predominantly observed. The cervical lymph node (92%) was the most frequently affected area. Among the different patterns of the condition, Pattern B, which is characterized by the presence of epithelioid granuloma along with caseous necrosis, was found to be the most common (53%). In contrast, Pattern C, which is marked by caseous necrosis without the presence of epithelioid granuloma, exhibited the highest positivity for acid-fast bacilli (80%). The difference in AFB positivity among the patterns was statistically significant (P-value= 0.0003). Conclusion: FNAC is an effective and economical diagnostic tool for tuberculous lymphadenitis, particularly in resource-limited settings. The study found that Pattern B (epithelioid granuloma with caseous necrosis) was the most common, while Pattern C (caseous necrosis without epithelioid granuloma) exhibited the highest AFB positivity. FNAC, combined with ZN staining, enhances the accuracy of tuberculosis diagnosis, minimizing the need for invasive biopsies. Given the high prevalence of tuberculosis, FNAC should be the first-line investigation for patients presenting with superficial lymphadenopathy, ensuring timely diagnosis and treatment.
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spelling doaj-art-9c5cb32a19af4a63a2a4df6707bf396f2025-08-20T03:13:21ZengZabansaraye Parsian Novin Mehr InstituteJournal of Current Oncology and Medical Sciences2783-31272025-03-015110361044An examination of the cytomorphological trends in tuberculous lymphadenitis at a tertiary care hospital of southern AssamSukanya Choudhury0Payel Hazari1Nicky Choudhury2Shah Alam Sheikh3Department of Pathology, Silchar Medical College and Hospital, IndiaDepartment of Pathology, Silchar Medical College and Hospital, IndiaDepartment of Pathology, Silchar Medical College and Hospital, IndiaDepartment of Pathology, Silchar Medical College and Hospital, IndiaIntroduction: Tuberculous lymphadenitis is a leading cause of lymph node enlargement accounting for 195 per 1,00,000 population in India. Fine needle aspiration cytology (FNAC) is rapid and economical compared to other tests and thus plays a crucial role in diagnosing this condition. It prevents unnecessary biopsy of lymph nodes and it can be used for collection of material for cytomorphological and bacteriological examination. This study aimed to assess the cytomorphological patterns of tuberculous lymphadenitis and correlate them with Ziehl-Neelsen (ZN) staining. Primary aim is to assess the cytomorphological patterns of tubercular lymphadenitis and to correlate with the bacteriological results using ZN staining. Materials and methods: The FNAC results of 100 cases diagnosed with tuberculous lymphadenitis over a period of one year were analyzed from the cytopathology section of Silchar Medical College and Hospital. The findings were classified into three patterns: pattern A - epithelioid granuloma in absence of caseous necrosis, pattern B - epithelioid granuloma with caseous necrosis, and pattern C - caseous necrosis in absence of epithelioid granuloma. The cytomorphological patterns were then correlated with acid-fast bacilli (AFB) positivity. Results: In individuals between the ages of 21 and 30, tuberculous lymphadenitis was predominantly observed. The cervical lymph node (92%) was the most frequently affected area. Among the different patterns of the condition, Pattern B, which is characterized by the presence of epithelioid granuloma along with caseous necrosis, was found to be the most common (53%). In contrast, Pattern C, which is marked by caseous necrosis without the presence of epithelioid granuloma, exhibited the highest positivity for acid-fast bacilli (80%). The difference in AFB positivity among the patterns was statistically significant (P-value= 0.0003). Conclusion: FNAC is an effective and economical diagnostic tool for tuberculous lymphadenitis, particularly in resource-limited settings. The study found that Pattern B (epithelioid granuloma with caseous necrosis) was the most common, while Pattern C (caseous necrosis without epithelioid granuloma) exhibited the highest AFB positivity. FNAC, combined with ZN staining, enhances the accuracy of tuberculosis diagnosis, minimizing the need for invasive biopsies. Given the high prevalence of tuberculosis, FNAC should be the first-line investigation for patients presenting with superficial lymphadenopathy, ensuring timely diagnosis and treatment.https://submission.journalofcoms.com/index.php/JCOMS/article/view/297cytomorphological patternstuberculous lymphadenitisziehl-neelsen (zn) stainingacid-fast bacilli
spellingShingle Sukanya Choudhury
Payel Hazari
Nicky Choudhury
Shah Alam Sheikh
An examination of the cytomorphological trends in tuberculous lymphadenitis at a tertiary care hospital of southern Assam
Journal of Current Oncology and Medical Sciences
cytomorphological patterns
tuberculous lymphadenitis
ziehl-neelsen (zn) staining
acid-fast bacilli
title An examination of the cytomorphological trends in tuberculous lymphadenitis at a tertiary care hospital of southern Assam
title_full An examination of the cytomorphological trends in tuberculous lymphadenitis at a tertiary care hospital of southern Assam
title_fullStr An examination of the cytomorphological trends in tuberculous lymphadenitis at a tertiary care hospital of southern Assam
title_full_unstemmed An examination of the cytomorphological trends in tuberculous lymphadenitis at a tertiary care hospital of southern Assam
title_short An examination of the cytomorphological trends in tuberculous lymphadenitis at a tertiary care hospital of southern Assam
title_sort examination of the cytomorphological trends in tuberculous lymphadenitis at a tertiary care hospital of southern assam
topic cytomorphological patterns
tuberculous lymphadenitis
ziehl-neelsen (zn) staining
acid-fast bacilli
url https://submission.journalofcoms.com/index.php/JCOMS/article/view/297
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