Study of fine needle aspiration cytology in lymphadenopathy with special reference to acid-fast staining in cases of tuberculosis

The present study was conducted to evaluate the usefulness of FNAC as a diagnostic tool in 1000 patients of lymphadenopathy. Fine needle aspiration was performed in all the patients following through clinical examination and slides were stained with H & E. PAP and Ziehl Neelsen stains. The results of FNAC were further correlated with paraffin embedded sections of tissue blocks. Eight hundred and sixty-four cases (86.4%) were of benign lymphadenopathy; out of which 536 (53.6%) cases were of reactive nature and 328 cases (32.8%) were tubercular. The remaining 136 (13.6%) cases were of malignant lymphadenopathy, consisting 45 (4.5%) cases of primary malignancies i.e. lymphomas and 91 (9.1%) cases of metastasis to lymph nodes. Out of 328 cases, Z-N positivity for AFB was found in 152 cases (46.4%) and Mantoux test was positive in 180 cases (54.9%). On correlation of FNAC findings with histopathology; sensitivity and specificity was found out to be 91.6% and 99%, respectively, with diagnostic accuracy of 97.3% in cases of benign lesions. The same being 97%, 97.5% and 97.4%, respectively in tubercular lesions. The sensitivity, specificity and diagnostic accuracy was 100% each in malignant lesions. FNAC of lymphnodes is an excellent first line method, for investigating the nature of the lesions, as it is economical and convenient alternative to open biopsy.