Study of cytomorphological spectrum of tuberculous lymphadenitis and correlation with AFB positivity

A prospective study of lymph node FNAC was done in 500 cases presenting with tuberculous lymphadenitis over a duration of 6 months. Most of the patients were in the age group of 21-40 years, with female to male ratio of 1.9:1. Lymph node enlargement was noted in all the cases, wherein the lymph nodes were multiple, soft to firm and matted in 152 cases (30.4%) and single and discrete in 348 cases (69.6%). The most common group involved was the cervical group of lymph nodes (87.2%), followed by the axillary group (9.4%). Most cases showed whitish aspirates (56%). 21% cases showed cheesy appearance of aspirates. Associated history of contact was found in 97 cases (19.4%). 142 cases (28.4%) had past history of tuberculosis, out of which 52 cases had completed antitubercular treatment (ATT) for 9 months, while 42 cases were defaulters who had not completed ATT course. Epithelioid granuloma with necrosis (63.6%) pattern was the most common followed by epithelioid granuloma without necrosis (22.4%). 9 HIV seropositive cases (1.8%) were seen, out of which, epithelioid granuloma with necrosis and only caseous necrosis were seen in 3 cases (33.33%) each. AFB positive cases were 36%. Necrotizing lymphadenitis showed maximum AFB positivity (95.55%), which was followed by necrotizing and suppurative lymphadenitis which showed 92% AFB positivity. We did not encounter any complications during and after aspiration procedure.