Title: Profile of Nodal Tuberculosis at a Tertiary Care Centre, Gwalior, India
Authors: Dr Jyoti Priyadarshini Shrivastava, Dr Poonam Woike, Dr LokeshTripathi, Dr Rajesh Gaur, Dr K.S Mangal
DOI: http://dx.doi.org/10.18535/jmscr/v3i10.44
Lymphadenitis is the most common extra pulmonary manifestation of tuberculosis. Tuberculous lymphadenitis is considered to be the local manifestation of the systemic disease. A high index of suspicion is needed for the diagnosis of tuberculous lymphadenitis which is known to mimic a number of pathological conditions. Cytomorphology proves to be a valuable tool in diagnosing these cases. The aim of our study is to evaluate the utility and limitations of fine needle aspiration cytology and various cytomorphological presentations in reference to tuberculous lymphadenitis. In a study period from January 2010 – December 2014,1188 superficial lymphnodes, were selected for FNA and subjected to cytological evaluation by Giemsastained smears. Incidence of tuberculous lymphadenitis was 54.95% (p value- 0.035). Cervical region was the commonest site of involvement with solitary lymphadenopathy as the most common presentation in contrast to matted lymph nodes as reported by others.Fine needle aspiration cytology is a safe, cheap, rapid outpatient procedure requiring minimal instrumentation and is highly sensitive to diagnose tubercular lymphadenitis. Key Words- Tuberculosis, Cytomorphology, Lymphadenitis, Epithelioid cells 1. Refe intro- Kumar V, Abbas AK, Fausto N, Mitchell RN (2007).Robbins Basic Pathology (8th ed.). Saunders Elsevier. pp. 516–522. ISBN 978-1-4160-2973-1. 2. Kumar A. Lymph node tuberculosis. In: Sharma SK, Mohan A. eds (2009) Tuberculosis. 2nd ed. New Delhi: Jaypee Brothers Medical Publishers, 397-409. 3. Global tuberculosis control: surveillance, planning, financing: WHO report 2008. 4. "Tuberculosis Fact sheet N°104". World Health Organization. November 2010. Retrieved 26 July 2011. 5. Tuberculosis World Health Organization. 2002. 6. World Health Organization (2009). "Epidemiology" (PDF) Global tuberculosis control: epidemiology, strategy, financing. pp. 6–33. ISBN 978-92-4-156380-2. 7. "Improved data reveals higher global burden of tuberculosis". who.int. 22 October 2014. Retrieved 23 October 2014. 8. GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet 385 (9963): 117–171.doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442. 9. World Health Organization (2011). "The sixteenth global report on tuberculosis" (PDF). 10. Lawn, SD; Zumla, AI (2 July 2011). "Tuberculosis". Lancet 378 (9785): 57–72. doi:10.1016/S0140-6736(10)62173-3.PMID 21420161. 11. Dolin, [edited by] Gerald L. Mandell, John E. Bennett, Raphael (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases (7th ed.). Philadelphia, PA: Churchill Livingstone /Elsevier. pp. Chapter 250. ISBN 978-0-443-06839-3. 12. al.], edited by Peter G. Gibson ; section editors, Michael Abramson ... [et (2005). Evidence-based respiratory medicine (1. publ. ed.). Oxford: Blackwell. p. 321. ISBN 978-0-7279-1605-1. 13. Jindal, editor-in-chief SK (2011). Textbook of pulmonary and critical care medicine. New Delhi: Jaypee Brothers Medical Publishers. p. 549. ISBN 978-93-5025-073-0. 14. Golden MP, Vikram HR (2005). "Extrapulmonary tuberculosis: an overview".American Family Physician 72 (9): 1761–8. PMID 16300038 15. Backer AID, Mortele KJ, Keulenaer BLD, Parizel PM (2006) Tuberculosis: epidemiology, manifestations, and the value of medical imaging in diagnosis. JBR-BTR 89: 243-250. 16. Bailey and Love’s Short Practice of Surgery. 19th Edition, 1985, pages 601 and 610. 17. Ergete W and Bekele A. Acid fast bacilli in aspiration smears from tuberculous patients. Ethiop J Health Dev 2000; 14(1): 99-104. 18. Ahmad SS, Akhtar S, Akhtar K, Naseem S, MansoorT,Khalil S. Incidence of tuberculosis from study of fine needle aspiration cytology in lymphadenopathy and acid fast staining. Ind J Community Medicine 2005; 30(2):63-5. 19. RuchiKhajuria, KC Goswami, K Singh, VK Dubey. Pattern of Lymphadenopathy on Fine Needle Aspiration Cytology In Jammu. JK Science. 2006;190(3):158–60. 20. Nidhi Paliwal, Sapna Thakur, Shalini Mullick, Gupta Kumud. FNAC In Tuberculosis Lymphadenitis : Experience From A Tertiary Level Referral Centre. Indian J Tuberc. 2011;58:102–07 21. Nitin Chawla, Sanjeev Kishore, Sandip Kudesia. FNAC of Lymph Node Disorders. . Indian Medical Gazette. 2012:312–15. 22. Raghab Mohapatra Prasanta, Kumar Janmeja Ashok. Tuberculosis Lymphadenitis. JAPI. 2009;57:585–90. 23. RK Narang, S Pradhan, RP Chaturvedi, S Sheridan. Place of Fine Needle Aspiration Cytology In The Diagnosis of Lymphadenopathy. Ind J Tub. 1990;37: 29–31. 24. I Gomes, E Trindade, O Vidal, et al. Diagnosis of sputum smear–negative forms of pulmonary tuberculosis by transthoracic fine needle aspiration. Tubercle. . 1991;72:210–13. 25. DK Das, JN Pank, KL Chachra, et al. Tuberculosis lymphadenitis: correlation of cellular components and necrosis in lymph node aspirate with AFB positivity and bacillary count. Indian J Pathol Microbiol. 1990;33:1–10.Abstract
References