Incidence of tubercular lymphadenitis in cases of cervical lymphadenopathy by fine needle aspiration cytology—A single center study

INTRODUCTION: Using fine needle aspiration cytology (FNAC) to ascertain the incidence frequency of tubercular lymphadenitis in patients screened with cervical lymphadenopathy in a resource-scarce environment. METHODS: This is a cross-sectional study analyzing FNAC samples from patients with cervical lymph node swelling, focusing on the cytological findings related to tuberculosis (TB). It is a district-level study from Pithoragarh (India), conducted on patients presenting with cervical lymphadenopathy in a healthcare facility, resorting to FNAC as the diagnostic technique. RESULTS: In this study, 82 (77.35%) of cases were found to exhibit a tubercular pattern. Ziehl-Neelsen staining confirmed that 21 (25.60%) of them are positive for acid-fast bacilli (AFB). Most AFB-positive cases 13 (48.14%), were associated with caseous necrosis, while 6 (18.75%) exhibited necrotizing granulomatous lymphadenitis. No significant differences were noted in the incidence of disease based on age or gender. CONCLUSIONS: FNAC proves valuable for initial screening and follow-up of patients with lymphadenopathy; unlike excision biopsies, which sometimes lead to complications, such as sinus formation in tuberculous lymph nodes. The detection of granulomatous inflammation, consistent with TB, along with AFB positivity, provides a strong basis for initiating anti-tubercular therapy promptly. FNAC's affordability and its diagnostic relevance make it an ideal method for diagnosing tuberculous lymphadenitis in resource-constrained environments.