Ayesha Sarwar, Anwarul Haque, Sara Aftab, Mahera Mustafa, Ambreen Moatasim, Saadia Siddique, Aaliya Sani.
Spectrum of morphological changes in Tuberculous lymphadenitis.
Int J Pathol Jan ;2(2):85-90.

Introduction: Tuberculous lymphadenitis is one of the most common causes of lymphadenopathy. Fine needle aspiration cytology is the most economical, quick and easy way of its diagnosis. Familiarity with cytological features of lymphadenopathy is essential in order to arrive at a correct diagnosis. Objective: The objective of the study is to describe the spectrum of morphological features seen on cytological smears of tuberculous lymphadenitis. Material and Methods: One hundred consecutive cases of tuberculous lymphadenitis, performed in Pakistan Institute of Medical Sciences, Islamabad, from July 2003 to August 2004, diagnosed on fine needle aspiration. were reviewed. Results: The results of our study showed that in early lesions there is suppuration and caseation necrosis. As immunity increases first ill defined (in exudative lesions) and then well defined granulomas are formed. Neutrophils as nuclear dust are present in early lesions and they are absent in late lesions when granulomas are well defined. Lymphocytes are maximum in the late granuloma phase while in intense caseous phase they are absent. Plasma cells are present with well defined granulomas. Conclusions: Tuberculous infection of a lymph node follows a spectrum from early exudative to caseous to late fibro-calcification phase. Presence of neutrophils does not rule out tuberculosis and one most look for other features like epitheloid cells and caseation necrosis.

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