Ziehl Neelsen and Auramine Rhodamine staining: A comparative evaluation from North India

Introduction: Tubercular lymphadenitis can be presumptively diagnosed morphologically on fine-needle aspiration cytology of lymph node. Fine-needle aspiration cytology is now widely utilized as a first line diagnostic procedure in the diagnosis of palpable masses, including peripheral lymphadenopathy. Ziehl-Neelsen (ZN) method for acid-fast bacilli plays a key role in the diagnosis and also for the monitoring of treatment in tuberculosis. Its major disadvantage is low sensitivity ranging from 20% to 43%. Present study is to compare the efficacy of ZN staining method and fluorescent method using Auramine-Rhodamine in diagnosis of Tubercular Lymph Adenitis. Methods: 100 samples were taken in this hospital based observational study. Patients with palpable swelling suspected to be tubercular in nature and confirmed by cytomorphology were included. Staining was done using Ziehl Neelsen and Auramine Rhodamine staining method. Comparison was made using grade for bacilli seen under the microscope. Results: Maximum number of patients sample was seen in age group of 20-30 years. Female preponderance was seen. There was 59% samples where the aspirate was taken from the cervical lymph nodes. Maximum sample were seen of caseation with epitheloid cells followed by non-caseation with epitheloid cells. Positivity of aspirate was higher in staining by Auramine Rhodamine stain as compared to Ziehl Neelsen stain which was statistically significant.