A Study of Cytomorphological Spectrum in Tuberculous Lymphadenitis from Northern India

Tuberculous lymphadenitis is one of the most common causes of lymphadenopathy. It shows a vast array of morphological pattern on fine needle aspiration cytology. One should be aware of these cytomorphological patterns to arrive at a correct diagnosis.

To analyze pathological spectrum of involved lymph nodes by tuberculosis on cytological smears.

The study was conducted in Department of pathology, Santosh Medical College and Hospitals. Ghaziabad, Uttar Pradesh. 120 consecutive cases suspected as tubercular lymphadenopathy, who presented during June 2010 to July 2011, were reviewed. Cytological smears, ancillary techniques and biopsy material were studied to arrive at the diagnosis.

The results of our study showed that a wide spectrum of morphological changes were present on cytology. These included presence of caseation necrosis, epithelioid cell granuloma, multinucleated giant cells, lymphocytes, neutrophils, plasma cells, fibrosis and calcification. Presence of neutophils along with necrotic material does not rule out tuberculosis. This may be the earliest phase of tuberculosis and a repeat fine needle aspiration cytology may increase the diagnostic yield as the disease progresses.

It was concluded that in tuberculous lymphadenopathy, morphological spectrum varies from early exudative to caseous to late fibrocalcific phase and fine needle aspiration cytology provides a reliable, safe, rapid and economical method of diagnosing these patients with accuracy.