European Journal of Cardiovascular Medicine

Background:  Tuberculosis is a specific infectious disease caused by bacteria belonging to the "Mycobacterium tuberculosis complex". It presents a great social and economic problem and is one of the major factors responsible for high morbidity and mortality in India. The incidence of tuberculous cervical lymphadenopathy accounts for two third of extra pulmonary tuberculous lymphadenopathy. Higher proportion of tuberculous origin is because of greater incidence of pulmonary tuberculosis in our country. Perhaps there are many other causes of lymphadenopathy which are usually misdiagnosed as tuberculosis. Thus, it has been a common problem for both the clinicians as well as the pathologists to diagnose tuberculosis. Methods and Materials: The present work is carried out in 100 clinically suspected cases of tuberculous cervical lymphadenitis attending E.N.T., Surgery, Paediatrics and Medicine Department of central India institute as an outdoor/indoor patient during the period of one year. Patients with enlarged cervical lymph nodes with a history suggestive of tuberculosis were included after taking an informed consent. Results: Study was conducted on 100 clinically suspected cases of tuberculous cervical lymphadenitis, Tuberculosis was diagnosed in 57% cases by FNAC, smear and culture together, the maximum incidence of tuberculosis was observed in second and third decades, Females were more affected (64%) than males with the ratio of 1:2.3. FNAC showed accuracy of 42%, 30% cases were AFB smear positive in our study which nearly matches to other authors. The culture studies could diagnose 57 cases as tuberculous and 4 cases as non-tuberculous cervical lymphadenitis. Culture positive was higher in granulomatous necrotic lesions. Sensitivity, specificity and predictive values of culture study were significantly higher than FNAC and smear. These methods of investigation require considerable experience and confidence of the pathologist who perform the procedure for better results. When culture was taken as Gold Standard, cytology was found to be more sensitive than smear. Conclusions: From this study we concluded that Both FNAC and smear are quick, simple, less traumatic and cost-effective methods and are used as routine investigating procedures in OPDs of urban and semi-urban hospitals. Simplicity of these techniques (FNAC & Smear) combined with early availability of results and good diagnostic accuracy warrants their clinical application. Missed cytological diagnosis and isolation of non-tuberculous mycobacteria justify the use of culture studies in all suspected tuberculous lymphadenitis cases.