Fine needle aspiration cytology for suspected tuberculous lymphadenitis : a feasible solution for a diagnostic dilemma in Sudan

Abstract EN

Background : Tuberculosis is a common health problem in Sudan.

Tuberculous lymphadenitis is one of the most frequent causes of lymphadenopathy.

In most of these cases sputum as well as other diagnostic routine tests are negative.

Objective : To evaluate the usefulness of fine needle aspiration cytology (FNAC) as a diagnostic tool for tuberculous lymphadenitis and to describe the cytomorphology of the smears.

Material and Methods : This is a prospective hospital-based study conducted in Khartoum during the period from February 2011 to January 2012.

Eighty five patients with a clinical suspicion of tuberculous lymphadenopathy were included.

Direct smears were prepared and stained with Diff Quick (DQ) and Ziehl-Neelsen (ZN) stains.

Results : of the 85 patients, 52 (61.2 %) were females with 1.5 : 1 female to male ratio.

The mean age was 31.6 years (range 2 - 70 years).

The most frequent site involved was the cervical lymph node group, 58 (68.2 %) cases.

Seventy five (88.3 %) smears showed necrotizing granulomatous lymphadenitis (with or without detected epithelioid cells), and 10 (11.7 %) smears were non necrotizing granulomatous lymphadenitis, only epithelioid and inflammatory cells detected.

Positive smears for acid fast bacilli (AFB) by ZN stain were observed in 40 (47 %) cases.

Conclusion : FNAC is a simple and inexpensive method for diagnosis of tuberculous lymphadenitis, and can obviate the need for surgical excision.

Combination of FNAC with ZN stain is valuable and recommended as first line diagnostic modality in suspected cases.