Cytomorphological study of lymph node lesions at a tertiary care center

Abstract

Introduction: Lymphadenopathy is one of the most common clinical presentations of patients attending the outpatient department. The degree and pattern of morphological changes depend on inciting stimulus and the intensity of the response. Fine-needle aspiration cytology (FNAC) is an important procedure in establishing the diagnosis of various lymph node lesions. It is a widely accepted, accurate, sensitive, and specific test used in an outpatient setting. Methodology: An observational study was carried out at the department of pathology of a tertiary care hospital in North India from July 2019 to February 2020. A total of 100 lymphadenopathy cases were taken. Smears were stained with Giemsa and categorized according to the cytomorphological pattern. Ziehl - Neelsen (ZN) stain was done in clinically suspicious cases of tuberculosis (TB). Data regarding brief history, site, age, and cytomorphologic features were collected and analyzed. Results: Out of 100 cases of lymph node aspirations, 70 cases showed features of tubercular lymphadenitis followed by reactive lymphadenitis, 29 cases while 1 malignancy. TB was prevalent in all age groups. Conclusion: Lymph node FNAC is a simple, cost-effective investigation with great importance in view of high prevalence of TB in our country, where an atypical presentation of TB can be screened. Purulent aspirate smears which do not show typical features of TB can be dismissed as acute suppurative lymphadenitis in the absence of ZN staining. Acid-fast bacillus positivity in such cases confirms the diagnosis and helps in better patient management.