Title: Cytopathology of Lymphadenopathy in Patients of Chenab Valley
Authors: Dr Nazia Tabassum, Dr Altaf Malik, Dr Sumat-Ul Khurshid
DOI: https://dx.doi.org/10.18535/jmscr/v8i1.85
Abstract
Background: Fine-needle aspiration (FNA) cytology is a simple, economical, highly accurate tool in the diagnosis of tuberculous and non-tuberculous lesions of Lymph nodes. It is also used for sample collection for ancillary studies such as Zeihl-Nelsen (Z-N) stain for acid fast bacilli (AFB) and CBNAAT (Cartridge based nucleic acid amplification testing) for confirmation of Mycobacterium tuberculosis and rifampicin resistance as well as culture and molecular biologic studies.
Enlarged Lymph nodes are a prime target for Fine Needle aspiration (FNA). In an adult, lymphadenopathy is an immediate source of concern and unless the cause is evident, the enlarged node is usually aspirated. In children lymphadenopathy is common and usually the result of reactive hyperplasia ;for this reason it is often watched and not aspirated .Nevertheless, FNA is easily applicable to children also if lymphadenopathy persists.
In studies involving multiple sites, AFB positivity by Z-N ranges from 23% to 45%. The positive rate of mycobacterium culture from FNA material ranges from 20.8% to 83%. A few limitations include sampling and interpretation error and differential diagnostic problems.
Material and Methods: This prospective observational study was conducted in the department of pathology GMC Doda over a period of 8 months from May2019- December 2019 .The study population included 47 cases.
FNAC of enlarged lymphnodes was done with 21-22 gauge needle and 20ml dispovan syringe using Frenzens Handle by the pathologists of GMC doda using all the aseptic precautions.
Results: 22 cases were diagnosed as Non-specific reactive lymphadenitis,18 as Chronic granulomatous lymphadenitis,2 as Acute Suppurative lymphadenitis,1 as Non –Hodgkins Lymphoma , 1 case as Metastatic deposits of P.D SCC,1 case as metastatic deposits of Malignant Melanoma, 1 case as metastatic deposits of Duct cell carcinoma breast and 1 case as small lymphocytic lymphoma /Chronic lymphocytic leukemia.
Conclusion: To conclude, FNA is non-invasive procedure and helps in making accurate diagnosis of various lesions in both superficial and deep nodes in the body without causing any complications to the patients and is done as an OPD procedure without any hospital stay and is a cost effective and relatively painless procedure. But whenever there is doubt in diagnosis, repeat sample can be taken without any delay for cytopathology as well as for Ancillary studies.
Keywords: Cytopathology, Tuberculosis, casseous necrosis, Lymphnode, Langhan giant cells.
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