A CLINICO-PATHOLOGICAL STUDY ON CYTOLOGICAL SCREENING OF BRONCHOALVEOLAR LAVAGE AND SUBSEQUENT CORRELATION WITH ADENOSINE DEAMINASE, GENEXPERT MTB IN SUSPECTED SPUTUM NEGATIVE PULMONARY TUBERCULOSIS

Abstract

BACKGROUND: Sputum negative pulmonary tuberculosis is a world-wide burden on health budget. Clinico- radiologically suspected sputum negative pulmonary tuberculosis needs to be diagnosed using cytopathology along with ADA levels and GeneXpert MTB tests of BAL fluid obtained through bronchoscopy. AIM: To interpret the cytological screening of bronchoalveolar lavage and subsequent correlation with adenosine deaminase, genexpert mtb in suspected sputum negative pulmonary tuberculosis. METHODS: Patients visiting Pulmonary Medicine outdoor of R.GKAR Medical College Hospital, who are clinico radiologically being suspected as pulmonary tuberculosis but are sputum smear AFB negative on two consecutive samples. The study group includes these patients who are willing to undergo bronchoscopy, in whom there are neither any medical contraindications nor other miscellaneous restraints i.e. the study group contains cases of pulmonary TB as well as other infectious malignant non-infectious lung diseases. RESULT: Of the 61 patients, 41(67.2%) patients were male and 20(32.8%) patients were female. The average age of male patients was 51.71years and the average age of female patients was 39.35years.The mean ADA level of BAL fluid in patients with Pulmonary Tuberculosis was 22.54 U/L (Normal level – less than 30 U/L) and mean ADA level of BAL fluid in patients without Pulmonary Tuberculosis was 4.76 U/L (Normal level – less than 30 U/L). CONCLUSION: Cytology of bronchoalveolar lavage along with adenosine deaminase and GeneXpert MTB are important diagnostic and screening tools in suspected sputum negative pulmonary tuberculosis. As it can detect different kinds of inflammatory and other types of cells, it can also help in choosing the appropriate therapeutic procedure / modality for a disease.