Author(s): Gupta SK, Chugh TD, Sheikh ZA, alRubah NA
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Abstract One hundred two of 272 cases of cytodiagnosis of tuberculous lymphadenitis were subjected to mycobacterial examination by Ziehl-Neelsen staining on direct and concentration smears and by culture. Cytomorphologically the cases were categorized into four types: 1, predominantly necrotic material; 2, typical caseating epithelioid cell granulomas and giant cell formation; 3, only noncaseating epithelioid cell granulomas with or without giant cells; and 4, doubtful presence of epithelioid cells. Ziehl-Neelsen staining for acid-fast bacilli (AFB) was positive in 25\% in direct smears, 26.5\% in concentration smears and 29.5\% in both combined. The cultures for mycobacteria were positive in 49\%; combined smear and culture positivity was found in 56.9\%. Maximum culture positivity was seen in cases with type 1 smears (56.9\%) followed by types 2 (44\%) and 3 (40\%). The percentage of AFB positivity was similar in type 1 and type 2 smears (32.2\% and 30\%, respectively); however, AFB were present in large numbers in type 1 smears as compared to type 2 and 3 smears. In type 3 smears AFB positivity was found in 20\% of cases. Cases with type 4 smears were negative for AFB in smears and culture. In eight cases (7.8\%) the smears were positive for AFB, whereas the cultures were negative, indicating that negative culture examination still does not exclude the possibility of tuberculosis. However, culture is essential to a characterization and determination of drug sensitivity.
This article was published in Acta Cytol
and referenced in Journal of Infectious Diseases & Preventive Medicine