EFFICACY OF FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) IN THE DIAGNOSIS OF TUBERCULOUS LYMPHADENITIS AS COMPARED TO GENEXPERT IN A TERTIARY CARE HOSPITAL, PUNJAB, PAKISTAN

Background and Objectives Tuberculous lymphadenitis is a common extrapulmonary manifestation of tuberculosis which is difficult to accurately diagnose especially when resources are limited like in most of the progressive countries. The current research is focused on comparing the diagnostic utility and effectiveness of GeneXpert and Fine Needle Aspiration Cytology (FNAC) for accurate identification of tuberculous lymphadenitis. Materials & Methods This study was conducted at a tertiary care hospital, Punjab, Pakistan, from October 2022 to December 2023. A total of 150 patients with clinically suspected tuberculous lymphadenitis were included. FNAC and GeneXpert were performed on all patients in the study and the results were compared for accuracy of diagnosis. FANC results were analyzed for granulomatous inflammation and AFB presence. On the other hand, GeneXpert was used to detect Mycobacterium TB DNA and rifampicin resistance. Results FNAC identified granulomatous inflammation in 80% of cases. Sensitivity and specificity of FNAC remains 92.3% and 66.7% respectively. However, GeneXpert showed a sensitivity of 86.7% and detected rifampicin resistance in 10% of cases. Conclusion This comparative study concluded that although FNAC is initially a valueable tool for diagnosing tuberculous lymphadenitis, limitations in accuracy limits its reliability. However, the other diagnostic tool, GeneXpert provides comparatively higher diagnostic accuracy and is essential for detecting drug resistance. Therefore, this study recommends an integrated use of FNAC and GeneXpert to improve the diagnosis of Tuberculous lymphadenitis.