Cytomorphological evaluation of tuberculous lymphadenitis and its correlation with Ziehl–Neelsen staining and cartridge-based nucleic acid amplification test
Rajasree Chakrabarty, Ananya Das, Piyali Mitra, Sujata Ganguli, Nabanita Banerjee, Anjan Kumar DasAbstract
Background:
Tuberculous lymphadenitis accounts for a major proportion of extrapulmonary tuberculosis (TB) cases worldwide. Fine-needle aspiration cytology (FNAC) reveals characteristic cytomorphological patterns that are highly suggestive of TB. Ziehl–Neelsen (ZN) staining and the Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) performed on the aspirated material are routinely used to confirm the diagnosis.
Aims and Objectives:
To evaluate the cytomorphological patterns of tuberculous lymphadenitis and correlate them with ZN staining and CBNAAT results.
Materials and Methods:
This retrospective cross-sectional study was conducted at the authors’ institute from January 2023 to December 2023. Cytology smears, including ZN-stained smears, were reviewed, and CBNAAT reports were retrieved from the records. Statistical analysis was performed using Statistical Package for the Social Sciences version 21. Numerical data were presented as percentages, and categorical data were analyzed using Fisher’s exact test.
Results:
FNAC was performed in 210 cases presenting with lymphadenopathy, of which 85 (40.5%) were diagnosed with tuberculous lymphadenitis based on ZN staining and/or CBNAAT positivity. The predominant cytological pattern was necrotizing (caseating) granulomatous lymphadenitis. Acid-fast bacilli (AFB) were identified on ZN-stained smears in 56 cases (65.9%), and CBNAAT detected
Conclusion:
The cytomorphological features of tuberculous lymphadenitis, especially in cases of necrotizing lymphadenitis, showed a strong correlation with both ZN staining and CBNAAT results, underscoring their utility as effective screening tools.