Fine needle aspiration cytology in childhood TB lymphadenitis.
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Date
2009-12
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Abstract
Objective. To evaluate the efficacy of Fine Needle Aspiration Cytology (FNAC) to diagnose Tuberculous (TB) lymphadenitis
with compare to excision biopsy and to correlate TB lymphadenitis with clinical, cytological, radiological and mantoux test
features.
Methods. This was a prospective correlational study. FNAC was done by a pediatrician for 135 children with persisting
lymphadenitis after two weeks of antibiotic therapy in the period of January 2005 to June 2006 and compared with excision
biopsy in a tertiary care hospital.
Results. Forty Six cases (34.07%) were TB lymphadenitis diagnosed by FNAC. Excision biopsy and cytological correlation
was done in 100 cases. Sensitivity, specificity and diagnostic accuracy for TB lymphadenitis were found to be 98%, 100%
and 99% respectively. Positive and negative predictive values were 100 and 98 respectively. Large (>2cm) (86.9%), multiple
(52.1%), matted (47.8%), posterior cervical and submandibular group nodes with history of contact (P=0.0016), positive
mantoux test (P=0.0001) and Grade III and IV Protein Energy Malnutrition (PEM) (P=0.0041) were significantly seen in TB
lymphadenitis. Ziehl Neelson staining for Acid Fast Bacilli (AFB) was positive in 32.5% cases of TB Lymphadenitis.
Conclusion. Pediatrician himself can do FNAC which is an excellent first line method to diagnose TB lymphadenitis and it has equal accuracy to excision biopsy.
Description
Keywords
Excision biopsy, FNAC, Lymphadenitis, Malignant, Mantoux test, Tuberculosis
Citation
Balaji J, Sundaram S Shanmuga, Rathinam S Nataraja, Rajeswari P Amutha, Kumari M L Vasantha. Fine needle aspiration cytology in childhood TB lymphadenitis. Indian Journal of Pediatrics. 2009 Dec; 76(12): 1241-1246.