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Extrapulmonary tuberculosis in form of lymphonodes is the common presentation of tuberculosis in developing countries. Fine needle aspiration cytology helps in early diagnosis & treatment for tubercular lymphadenitis, which remains the cornerstone for the effective management of the disease. Aim: To study the cytological characteristics and compare with the bacteriological load with the help of Zeihl Neelsen stain. Materials and Methods: 445 smears were studied for a period of one year. Smears were categorized into 4 patterns Pattern A epithelioid cell granulomas without caseous necrosis, Pattern B -epithelioid cell granulomas with caseous necrosis, Pattern Ccaseous necrosis without granuloma, Pattern D – neutrophils with abundant caseous necrosis. Bacillary load was graded as 1+, 2+ and 3+ were compared with the cytological categories. A p value of <0.05 was considered significant. Results: Pattern A was observed in 16.7% cases, Pattern B in 18.3%, Pattern C in 37.8% & Pattern D in 27.2% of cases. Statistical significance was seen between cytomorphological pattern & AFB grade (p=0.026 & X=20.0639). It was found that pattern C& D showed the highest AFB grade of 3+ by a 2x2 analysis to test the degree of one hypothesis. Conclusion: FNAC is an useful tool in the early diagnosis of tubercular lymphadenitis avoiding the un necessary burden of surgical intervention. Maximum bacillary load was correlated with the patterns C & D.

A cytological study of smear characteristics and its correlation with bacillary load in tubercular lymphadenopathy