Extrapulmonary tuberculosis: Fine needle aspiration cytology diagnosis

Abstract

BACKGROUND: The increasing prevalence of extrapulmonary manifestation of tuberculosis with the HIV scourge is a cause for concern. OBJECTIVE: To determine the role of fine needle aspiration cytology (FNAC) in the diagnosis of extrapulmonary tuberculosis. PATIENTS AND METHODS: This is a consecutive 9-year analysis of patients with peripheral lymphadenopathy. All the patients had fine needle aspiration. Smears were made, fixed in 95% alcohol and stained with hematoxylin and eosin and Zeihl Neelsen stains. RESULTS: 48 patients, 31 males and 17 females, were analyzed. The mean age was 27.9 years. Aspirates were mainly from cervical lymph nodes. Four patients were HIV 1 seropositive. Macroscopically, 23 (48%) of the aspirates were purulent and 7 (14.6%) had caseous material. Microscopy showed granular eosinophilic material (caseation), multinucleated giant cells, epithelioid cells, neutrophils and lymphocytes. Staining for acid-fast bacilli was positive in 23 (48%) cases. CONCLUSION: Early diagnosis of extrapulmonary tuberculosis in a resource-limited setting can be achieved with fine needle aspiration cytology technique (FNAC). This will ensure prompt treatment and thus reduce attendant morbidity and mortality.