The Issue of Fine Needle Aspiration Cytology in the Diagnosis of Tuberculous Cervical Lymphadenitis in Iran Publisher



Hasibi M¹ ; Rezaii J¹ ; Rasoulinejad M¹ ; Yassin Z¹ Show Affiliations
Source: Australasian Medical Journal Published:2016

Abstract

Background Due to different reports about the value of fine needle aspiration cytology (FNAC) as a simple and minimal invasive diagnostic tool for extra-pulmonary tuberculosis, we attempted to demonstrate the sensitivity of FNAC in patients with cervical tuberculous lymphadenitis in Iran. We wanted to know if fine needle aspiration (FNA) is an accurate method as a first step in diagnosis or not. Methods This study covered a 14 year period identifying 137 patients with a pathological report of granulomatosis in excisional biopsy of lymphadenopathy in two tertiary referral hospitals of Tehran, Iran. The results of fine needle aspiration cytology (FNAC) in 67 patients with tuberculosis cervical lymphadenitis were evaluated. Results The FNA cytology showed granuloma with background necrosis in five patients (7.46 per cent) and granuloma with or without necrosis in 13 patients (19.40 per cent). Patients with positive results of FNAC had a longer duration of lymphadenopathy compared to other patients. Conclusion In this study, sensitivity of FNAC was reported to be low. The sensitivity of this method was 7.46 per cent (including pathology granuloma with background necrosis) and 19.40 per cent (total cases of granuloma with or without necrosis). It seems that the sensitivity of FNAC is significantly lower in patients with early cervical tuberculosis (TB) lymphadenitis. Combining acid-fast bacillus (AFB) staining and non-culture methods like polymerase chain reaction (PCR) could increase FNA sensitivity in these patients. © 2016, Australasian Medical Journal Pty Ltd. All rights reserved.