Transthoracic (percutaneous) fine needle aspiration cytology diagnosis of pulmonary tuberculosis

Abstract

Objective: The present study was carried out to assess the utility of transthoracic (percutaneous) fine needle aspiration (FNA) cytology in the diagnosis of pulmonary tuberculosis. Design: During a period of 6 years (1985-90), 202 ultrasound and computerized tomography (CT)-guided transthoracic FNA of pulmonary lesions were performed. Review of smears available in 190 cases revealed 38 (20%) cases of pulmonary tuberculosis. Age of the patients ranged from 11 months-75 years with a median of 40 years. The common clinical diagnoses were malignancy (14 cases), tuberculosis (8 cases) and pneumonitis (7 cases). The sites of FNA were lungs in 36 cases and pleural based lesions in 2 cases. Results: Epithelioid granuloma without necrosis (type 1 reaction) were observed in 4 (10.5%) cases. Epithelioid granuloma with necrosis (type 2 reaction) and necrosis without epithelioid granuloma (type 3 reaction) were seen in 17 (44.7%) cases each. The overall rate of AFB positivity was 45.8%. The rate of acid-fast bacilli (AFB) positivity in type 1, 2 and 3 reactions were 0%, 38.5% and 60.0% respectively. Conclusion: This study shows that transthoracic (percutaneous) FNA is a useful means for diagnosis of pulmonary tuberculosis, especially when the clinical and/or radiological features are non-specific or point towards malignancy rather than tuberculosis.