English

Abstract

The diagnosis of cervical tuberculous lymphadenitis has been performed by histological examination using excisional biopsy specimens. However a non-invasive diagnostic procedure alternative to invasive excisional biopsy has been required and fine needle aspiration cytology as well the polymerase chain reaction (PCR) techniques have become useful modalities. The aim of this study was to evaluate and compare different diagnostic modalities and establish their effectiveness in current conditions. We performed a retrospective study of two hundred patients of tuberculous cervical lymphadenitis admitted in the department of surgery, SAIMS Medical college and PG institute in a two year period from January 2011 to December 2012. Excision biopsy specimens and needle aspiration specimens were collected from all patients who were suspected as having cervical tuberculous lymphadenitis on the basis of clinical features, Mantoux test and other diagnostic techniques. The histopathological positive rates, the time period necessary for diagnosis, the rupture rate of the local skin lesion and the detection ratio of mycobacterium were compared between the two percutaneous approaches. The diagnosis of tuberculous lymphadenitis was successful in all cases either by cytological examination or with the histological approach. The sensitivity and the diagnostic efficacy of FNAC in detecting tubercular lymphadenitis were 87% and 80% respectively. The rupture rate of the local skin after the excisional biopsy was higher than that of the needle aspiration procedure . The time required for diagnosis was significantly longer than that of the needle aspiration procedure . Fine needle aspiration cytology is highly recommended as a less invasive method of diagnosis of cervical tuberculous lymphadenitis, but excision biopsy and histological examination is the gold standard.