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Cited by 2Lymphadenopathy Diagnosis and AnalysisDiagnosis and treatment of tuberculosisTuberculosis Research and Epidemiology

Cytomorphology of lymphadenopathy with a report on patterns of tuberculous lymphadenitis in a resource-limited setting

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Anand, Bakiarathana, Mariaselvam, Anand·2020·Journal of Current Research in Scientific Medicine
DOI 10.4103/jcrsm.jcrsm_16_20
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Abstract

Context: Lymphadenopathy is one of most common clinical presentations, for which fine-needle aspiration (FNA) is indicated as the first-line investigation since it is a reliable, rapid, simple, cost-effective procedure done in the outpatient department.Aims: The study was performed to assess the various cytomorphological patterns of the lymph node aspirates in patients presenting with peripheral lymphadenopathy.Subjects and Methods: The prospective study included 81 patients with complaints of peripheral lymphadenopathy on whom FNA was done in the Department of Pathology at our hospital. The smears were analyzed and categorized according to their cytomorphological patterns.Results: Of 81 patients, 30 were male and 51 were female. The male:female ratio was 1:1.7. The age of the patients ranged from 3 to 83 years, with a mean age of 35.2 years. Reactive lymphadenitis (48.15%) was the most common lesion followed by tuberculous lymphadenitis (33.33%). Acid–fast bacilli (AFB) positivity was noted in 13 out of 27 cases (48.15%) with tuberculous lymphadenitis. The cases of tuberculous lymphadenitis were further divided into three groups based on cytomorphology, of which Group 2 lesions (epithelioid granulomas with necrosis) were most common and Group 1 lesions (epithelioid granulomas without necrosis) were least reported. Group 3 lesions (necrosis without epithelioid granulomas) were all positive for AFB. There were nine cases (11.11%) of acute suppurative lymphadenitis and six cases (7.41%) of metastatic squamous cell carcinoma to the lymph nodes.Conclusions: FNA is an ideal tool which can be used as a basic investigation for the evaluation of lymphadenopathy. Reactive lymphadenitis followed by tuberculosis was the major cause of lymph node enlargement in our setup. Epithelioid granulomas with or without necrosis and/or AFB positivity on the cytological smears and with associated clinical symptoms should be considered as tuberculosis in our clinical setup unless proven otherwise.

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Authors
Anand, B., & Mariaselvam, A.
Corresponding author
Anand, Bakiarathana
ORCID
Anand, Bakiarathana
Venue
Journal of Current Research in Scientific Medicine
Publisher
Medknow
Published
2020
Volume
6
Issue
1
Pages
45
ISSN
2455-3069 (ISSN-L)
DOI
10.4103/jcrsm.jcrsm_16_20
OpenAlex
W3044979263
Cited by
2
References
25
Citations by year
2023: 2
FWCI
0.46
Type
journal article
Language
en
Open access
Licence
cc-by-nc-sa
Locations
  • Journal of Current Research in Scientific Medicine (publishedVersion, cc-by-nc-sa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Surgery › Lymphadenopathy Diagnosis and Analysis
  • Health Sciences › Medicine › Surgery › Diagnosis and treatment of tuberculosis
  • Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
Keywords
lymphadenopathy, tuberculous lymphadenitis, cell morphology, fine needle aspiration cytology, reactive lymphadenitis, epithelioid granulomas, acid-fast bacilli, metastatic squamous cell carcinoma, resource-limited settings

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