A COMPARATIVE STUDY BETWEEN ZIEHL NEELSEN STAINING AND FLUORESCENCE MICROSCOPY IN THE DIAGNOSIS OF TUBERCULOUS LYMPHADENITIS ON FINE NEEDLE ASPIRATION CYTOLOGY

Introduction: Tuberculosis is a leading cause of morbidity and mortality in India which requires early diagnosis for treatment and control of infection. Fine needle aspiration cytology (FNAC) and Ziehl Neelson (ZN) staining of FNA samples have low specicity and sensitivity respectively in tuberculous lymphadenitis due to paucicellular nature of the disease. Fluorescent Microscopy has a well established role in detection of tuberculosis. Recently, WHO has recommended its use in extrapulmonary tuberculosis as an initial diagnostic tool. Material and Methods: This is a prospective study performed in Department of pathology and included 80 patients of suspected symptoms of tuberculous lymphadenitis. Fine needle aspiration was done and the material was sent for Fluorescent Microscopy. The rest of the material was used for preparing H&E stained and Z-N stained smears. Out of the total 80 cases, 47 cases were positive Result: for AFB on ZN staining and 56 cases showed Fluorescent Microscopy positivity, thus proving the important role of Fluorescent Microscopy in diagnosing tuberculous lymphadenitis. This difference was also statistically signicant (p value <0.05). Combined Conclusion: use of FNAC, ZN staining and Fluorescent Microscopy gives maximum diagnostic yield, greatly improving diagnostic value specially in patients with low bacillary load, those are likely to be missed on FNAC & ZN staining by increasing the rate of detection of tuberculous lymphadenitis