DR R SOWMYA,VOLGA H,DR. S. BHUMINATHAN
DOI: https://doi.org/Introduction: Tuberculous lymphadenitis (LNTB) is the most common form of extrapulmonary tuberculosis (EPTB), often posing diagnostic challenges due to its varied clinical presentations. Fine Needle Aspiration Cytology (FNAC) and the Mantoux test are widely utilized for its diagnosis. This study evaluates the diagnostic accuracy of FNAC and the Mantoux test in detecting tubercular lymphadenitis.
Methods: A total of 150 patients with clinically suspected tuberculous lymphadenopathy were included. The study was conducted at the Department of Pathology, Saveetha Medical College, Chennai, from January 2023 to December 2023. Informed consent was obtained from all participants. FNAC was performed using a 20-23 gauge needle, and smears were stained with Hematoxylin and Eosin (H&E) and Papanicolaou (PAP) stains. The Mantoux test was conducted using an intradermal injection of 0.1 mL of purified protein derivative (PPD). Cases were classified into four cytomorphological patterns based on FNAC findings.
Results: Of the 150 cases, 92 (61.3%) were male, and 58 (38.7%) were female, with a mean age of 41.57 years. The most affected lymph nodes were cervical (89.3%). Mantoux positivity was observed in 135 (90%) cases. FNAC revealed four cytomorphological patterns: caseating epithelioid granulomas (44%), epithelioid cell granulomas without necrosis, necrosis without granulomas, and necrosis with suppuration. The Mantoux test exhibited a high sensitivity (100%) and a positive predictive value (90%).
Conclusion: The combined use of FNAC and the Mantoux test enhances the diagnostic accuracy of tuberculous lymphadenitis. FNAC provides a rapid and cost-effective method, while the Mantoux test serves as a useful adjunct, particularly in endemic regions. A positive Mantoux result in patients with unexplained lymphadenopathy should prompt further FNAC or biopsy to confirm the diagnosis. Integrating these diagnostic tools enables early detection and effective management of tubercular lymphadenitis.
