Cytomorphology in Tuberculous Lymphadenitis and Correlation With Acid Fast Bacilli Detection by Papanicolaou, Auramine-Rhodamine Fluorescence and Ziehl-Neelsen Techniques

IF 1 4区医学 Q4 MEDICAL LABORATORY TECHNOLOGY

Diagnostic Cytopathology Pub Date : 2025-05-28 DOI:10.1002/dc.25486

Seethalakshmi Viswanathan, C. P. Shroff

{"title":"Cytomorphology in Tuberculous Lymphadenitis and Correlation With Acid Fast Bacilli Detection by Papanicolaou, Auramine-Rhodamine Fluorescence and Ziehl-Neelsen Techniques","authors":"Seethalakshmi Viswanathan, C. P. Shroff","doi":"10.1002/dc.25486","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Tuberculosis (TB) is a common cause of lymphadenopathy in developing countries. Fine needle aspiration cytology (FNAC) along with acid fast bacilli (AFB) detection is an invaluable diagnostic test. Fluorescent methods for AFB detection have greater sensitivity as compared to the Ziehl-Neelsen (ZN) method.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The incidence of TB lymphadenitis was determined among all lymph nodes aspirated over 5 years, from January 1993 to May 1998 in an Indian referral hospital. Cytomorphological spectrum was studied in 234 smears, and AFB positivity was determined by Papanicolaou (PAP), Auramine-Rhodamine (AR) fluorescence as compared to the ZN method.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of a total of 6592 lymph node aspirates, 33.86% were diagnosed as tuberculosis; maximum patients were between 11 and 30 years (68.5%), with a female predominance. Cervical nodes were commonly involved (85.6%). Tuberculosis was diagnosed in 41.4% of the 55 patients diagnosed with HIV infection. Cytomorphology in 234 smears examined predominantly showed caseous necrosis with degenerating histiocytes (48.7%). PAP method was the most sensitive for AFB detection (73.1%), followed by AR (57.7%) and ZN (42.3%) and the rate of AFB detection and bacillary load increased with the presence of caseous necrosis and polymorphonuclear cells and decreased with epithelioid cells, presence of caseous necrosis being statistically significant (<i>p</i> < 0.05).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Incidence of tuberculous lymphadenitis is high in developing countries. FNAC along with AFB detection is a reliable and definitive diagnostic procedure. Fluorescent techniques are more sensitive than ZN method for AFB detection, with certain limitations. Further studies may need to be done to evaluate their diagnostic utility over ZN method.</p>\n </section>\n </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 8","pages":"402-412"},"PeriodicalIF":1.0000,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dc.25486","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diagnostic Cytopathology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/dc.25486","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Tuberculosis (TB) is a common cause of lymphadenopathy in developing countries. Fine needle aspiration cytology (FNAC) along with acid fast bacilli (AFB) detection is an invaluable diagnostic test. Fluorescent methods for AFB detection have greater sensitivity as compared to the Ziehl-Neelsen (ZN) method.

Methods

The incidence of TB lymphadenitis was determined among all lymph nodes aspirated over 5 years, from January 1993 to May 1998 in an Indian referral hospital. Cytomorphological spectrum was studied in 234 smears, and AFB positivity was determined by Papanicolaou (PAP), Auramine-Rhodamine (AR) fluorescence as compared to the ZN method.

Results

Of a total of 6592 lymph node aspirates, 33.86% were diagnosed as tuberculosis; maximum patients were between 11 and 30 years (68.5%), with a female predominance. Cervical nodes were commonly involved (85.6%). Tuberculosis was diagnosed in 41.4% of the 55 patients diagnosed with HIV infection. Cytomorphology in 234 smears examined predominantly showed caseous necrosis with degenerating histiocytes (48.7%). PAP method was the most sensitive for AFB detection (73.1%), followed by AR (57.7%) and ZN (42.3%) and the rate of AFB detection and bacillary load increased with the presence of caseous necrosis and polymorphonuclear cells and decreased with epithelioid cells, presence of caseous necrosis being statistically significant (p < 0.05).

Conclusion

Incidence of tuberculous lymphadenitis is high in developing countries. FNAC along with AFB detection is a reliable and definitive diagnostic procedure. Fluorescent techniques are more sensitive than ZN method for AFB detection, with certain limitations. Further studies may need to be done to evaluate their diagnostic utility over ZN method.

Abstract Image

查看原文本刊更多论文

结核性淋巴结炎的细胞形态学及其与抗酸杆菌巴氏法、Auramine-Rhodamine荧光和Ziehl-Neelsen技术检测的相关性。

背景：结核（TB）是发展中国家淋巴结病的常见病因。细针吸细胞学（FNAC）和抗酸杆菌（AFB）检测是一种宝贵的诊断试验。与Ziehl-Neelsen （ZN）方法相比，荧光法检测AFB具有更高的灵敏度。方法：对1993年1月至1998年5月在印度一家转诊医院进行的5年内所有淋巴结抽吸的结核性淋巴结炎的发生率进行测定。对234例涂片进行细胞形态学检测，并与锌法比较，采用巴氏法（PAP）、金胺-罗丹明（AR）荧光法检测AFB阳性。结果：6592例淋巴结抽吸中，33.86%诊断为结核；11 ~ 30岁患者最多（68.5%），以女性为主。常累及宫颈淋巴结（85.6%）。55例HIV感染患者中有41.4%被诊断为结核病。234例涂片细胞形态学检查主要显示干酪样坏死伴组织细胞变性（48.7%）。PAP法对AFB的检出率最高（73.1%），其次是AR法（57.7%）和ZN法（42.3%），AFB检出率和细菌载量随干酪样坏死和多形核细胞的存在而升高，随上皮样细胞的存在而降低，干酪样坏死的存在具有统计学意义(p)结论：结核性淋巴结炎在发展中国家发病率高。FNAC和AFB检测是一种可靠和明确的诊断方法。荧光技术检测AFB的灵敏度高于锌法，但有一定的局限性。可能需要做进一步的研究来评估它们相对于ZN方法的诊断效用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Diagnostic Cytopathology 医学-病理学

CiteScore

2.60

自引率

7.70%

发文量

163

审稿时长

3-6 weeks

期刊介绍： Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.