Authors :
Dr. Kuldip Pratap Patel; Dr. Jayantilal Arya; Dr. Atul Kumar Khare
Volume/Issue :
Volume 8 - 2023, Issue 2 - February
Google Scholar :
https://bit.ly/3TmGbDi
Scribd :
https://bit.ly/3ZLTL5x
DOI :
https://doi.org/10.5281/zenodo.7731071
Abstract :
Tuberculosis is a specific infectious disease
caused by bacteria belonging to the "Mycobacterium
tuberculosis complex".It presents a great social and
economic problem and is one of the major factors
responsible for the high morbidity and mortality in
India. The incidence of tuberculous cervical
lymphadenopathy now accounts for two third of the
extra pulmonary tuberculous lymphadenopathy. Most of
these are supposed to be tuberculous in origin because of
greater incidence of pulmonary tuberculosis in our
country. At the same time there are other causes of
lymph-adenopathy which are usually misdiagnosed as
tuberculosis. It has been a common problem for both to
clinicians as well as pathologist from to diagnose
tuberculosis.
Methos and materials: The present work is carried out
in 100 clinically suspected cases of tuberculous cervical
lymphadenitis attending E.N.T., Surgery, Paediatrics
and Medicine Department of central India institute as an
outdoor/indoor patient during the period of one year.
Patients with enlarged cervical lymph nodes with a
history suggestive of tuberculosis were included after
taking an informed consent.
Results: Study was done on 100 clinically suspected cases
of tuberculous cervical lymphadenitis, Tuberculosis was
diagnosed in 57% cases by FNAC, smear and culture
together, the maximum incidence of tuberculosis was
observed in second and third decades, Females were
more affected (64%) than males with the ratio of 1:2.3.
By FNAC 42% accuracy was obtained, 30% cases were
AFB smear positive in our study this rate of incidence is
nearer to other authors. In our culture study, 57 cases
were diagnosed as tuberculous and 4 cases as nontuberculous cervical lymphadenitis. Culture positive was
higher in granulomatous necrotic lesions. Sensitivity,
specificity and predictive values of culture study were
significantly higher than FNAC and smear. These
methods of investigation needs considerable experience
and confidence of a pathologist who perform the
procedure for a better result. When culture was taken as
Gold Standard, cytology was found to be more sensitive
than smear.
Conclusions: From this study we concluded that Both
FNAC and smear are quick, simple, less traumatic and
cost-effective methods and used as a routine
investigating procedure in OPD of urban and semiurban hospitals. Simplicity of these techniques (FNAC &
Smear) combined with early availability of results and
good diagnostic accuracy warrants their clinical
application.Missed cytological diagnosis and isolation of
non-tuberculous mycobacteria justify culture studies on
all suspected tuberculous lymphadenitis cases.
Tuberculosis is a specific infectious disease
caused by bacteria belonging to the "Mycobacterium
tuberculosis complex".It presents a great social and
economic problem and is one of the major factors
responsible for the high morbidity and mortality in
India. The incidence of tuberculous cervical
lymphadenopathy now accounts for two third of the
extra pulmonary tuberculous lymphadenopathy. Most of
these are supposed to be tuberculous in origin because of
greater incidence of pulmonary tuberculosis in our
country. At the same time there are other causes of
lymph-adenopathy which are usually misdiagnosed as
tuberculosis. It has been a common problem for both to
clinicians as well as pathologist from to diagnose
tuberculosis.
Methos and materials: The present work is carried out
in 100 clinically suspected cases of tuberculous cervical
lymphadenitis attending E.N.T., Surgery, Paediatrics
and Medicine Department of central India institute as an
outdoor/indoor patient during the period of one year.
Patients with enlarged cervical lymph nodes with a
history suggestive of tuberculosis were included after
taking an informed consent.
Results: Study was done on 100 clinically suspected cases
of tuberculous cervical lymphadenitis, Tuberculosis was
diagnosed in 57% cases by FNAC, smear and culture
together, the maximum incidence of tuberculosis was
observed in second and third decades, Females were
more affected (64%) than males with the ratio of 1:2.3.
By FNAC 42% accuracy was obtained, 30% cases were
AFB smear positive in our study this rate of incidence is
nearer to other authors. In our culture study, 57 cases
were diagnosed as tuberculous and 4 cases as nontuberculous cervical lymphadenitis. Culture positive was
higher in granulomatous necrotic lesions. Sensitivity,
specificity and predictive values of culture study were
significantly higher than FNAC and smear. These
methods of investigation needs considerable experience
and confidence of a pathologist who perform the
procedure for a better result. When culture was taken as
Gold Standard, cytology was found to be more sensitive
than smear.
Conclusions: From this study we concluded that Both
FNAC and smear are quick, simple, less traumatic and
cost-effective methods and used as a routine
investigating procedure in OPD of urban and semiurban hospitals. Simplicity of these techniques (FNAC &
Smear) combined with early availability of results and
good diagnostic accuracy warrants their clinical
application.Missed cytological diagnosis and isolation of
non-tuberculous mycobacteria justify culture studies on
all suspected tuberculous lymphadenitis cases.
