Clinical and cytological features in diagnosis of peripheral tubercular lymphadenitis - A hospital-based study from central India.

BACKGROUND: Tuberculosis lymphadenitis is difficult to diagnose clinically, and often the laboratory confirmation is not available in resource-poor countries. We describe here the symptoms, clinical characteristics, and results of cytological analysis in peripheral tuberculous lymphadenitis patients.

METHODS: One hundred and fifty-six patients with peripheral lymph node for cytological evaluation presenting to Department of Pathology, Acharya Vinoba Bhave Rural Hospital, Wardha, India were included in this study.

RESULTS: Sixty-nine cases were tuberculous lymphadenitis, with female to male ratio of 1.3:1. One or more constitutional symptoms were present in 59.4% of patients, with 89.9% of lymph nodes ≥2×2cm and the most common site of involvement was cervical lymph node (70.3%). The lymph nodes were multiple (85.5%), either discrete or matted. Cytomorphologically, hemorrhagic aspirate was observed in 29 cases, well-formed epithelioid cell granuloma with caseous necrosis was seen in 34 cases, and Zeihl Neelsen staining was positive in 45 cases. Correlation between character of aspirate and cytomorphological pattern was found highly significant.

CONCLUSION: These data suggest that constitutional symptoms and clinical and cytological features help in diagnosing cases of peripheral tubercular lymphadenitis and also open new frontiers to further research that affects the cytological features of these cases.