Muhammad Waqas, Muhammad Yousaf Khan, Naila Ismail.
Tuberculosis Lymphadenopathy in Cervical and Axillary Lymph Nodes as Determinded By Fine Needle Aspiration Cytology.
Pak J Chest Med Jan ;24(1):21-7.

Background: The extent of workup in patients with cervical lymphadeponpathy has always been controversial. Extensive workup in the absence of a histologic diagnosis indicative of a malignant process is unwarranted. Although open byopsy maybe necessary for certain benign conditions, its routine application for metastatic nodes is not advised. Objective: To determine the histological pattern of Fine needle aspiration cytology (FNAC) in patients of tuberculous cervical and axillary lymphadenopathy. Materials and methods: This was a correctional descriptive study conducted at advance medical laboratory, Peshawar - Pakistan from September 2016 - October 2017. Fifty Four patients presenting with enlarged cervical and axillary lymph nodes of all ages and both sexes referred to Advanced Medical Laboratory, Peshawar were included in the study. All the patients underwent FNAC. The slides were prepared and examined by the histopathologist. The diagnoses were recorded in predesigned proforma and results were drawn accordingly. Results: A total of 54 patients with cervical and axillary lymphadenopathy were included in the study. Age of the study sample ranged from 3-35 years, with mean age of 24 years ± 3 SD. Out of 54 patients, 40 (74%) patients were males and 14 (26%) patients were females. Male to female ratio was 2.8:1. FNAC findings showed that the commonest cause of lymphadenopathy was chronic granulomatous lesion, which was seen in about 43 (79%) cases, followed by 8 (15%) cases of reactive lymphoid hyperplasia, and 1 (2% ) case each of lymphoproliferative disorder and metastatic disease .Out of 43 cases of granulomatous lesion, about 30 (56.5%) cases had well formed granuloma suggestive of tuberculosis, while remaining 13 (24.5%) cases showed illformed granuloma. Evaluation of these 13 cases with sputum AFB, Montoux test and chest radiograph confirmed the diagnosis of tuberculosis in 6 (46%) cases only, while the remaining 7 (54%) cases could not be proved to have tuberculosis and so were labeled as having chronic non specific inflammation. Thus in total 36 (66.6%) patients had tuberculous lymphadenopathy. Conclusion: Tuberculous granuloma is the commonest cause of cervical lymphadenopathy in our setup, followed by reactive hyperplasia . FNAC is a simple and minimally invasive procedure for the workup of tuberculous lymph nodes. Thus, FNAC should be part of the initial evaluation of patients with cervical lymphadenopathy before determining the treatment plan.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com