Compared Fine Needle Aspiration Cytology with Surgical Excision in Diagnosis of Tuberculous Lymphadenitis
Abstract
Objective: To evaluate the diagnostic value of biopsy using of the component diagnostic modalities of FNAC (microscopic, cytology) and compare these with excision biopsy in the diagnosis of tuberculous lymphadenitis.
Methods: A retrospective examination of tuberculous lymphadenitis cases presenting to Samutsakorn Hospital in 1 October 2012 - 30 September 2013. The diagnostic sensitivities of each modality (microscopic, cytology/ histopathology) employed in FNAC were determined compared with surgical excision.
Result: 49 subjects having FNAC and 31 subjected having surgical biopsy as the initial investigation were compared. Among specimens obtained by FNAC, microscopic exam (AFB stain) was positive in 33% (16/49) and cytology was positive in 27% (13/49). For specimens obtained by surgical biopsy, microscopic exam (AFB stain) was positive 29% (9/31), histopathology was positive in 94% (29/31). 23 subjects were done bath FNAC and surgical biopsy. FNAC was correlated with histology and the sensitivity, specificity, accuracy in diagnosis of tuberculous lymphadenitis, positive predictive value and negative predictive value were calculated. The overall results showed a sensitivity of 28.57%, specificity of 100%, diagnostic accuracy of 34.78%, positive predictive value of 100% and negative predictive value of 11.76%.
Conclusion: Microscopic and cytology add relative little to the clinical utility of FNAC for diagnosis tuberculous lymphadenitis. It can be concluded that FNAC has low sensitivity and low diagnostic accuracy in diagnosis of tuberculous lymphadenitis. The histopathology from surgical biopsy were certain for diagnosis tuberculous lymphadenitis but invasive method compare with FNAC.
References
2. van Loenhout-Rooyackers JH, Richter C. Diagnosis and treatment of tuberlous lymphadenitis of the neck. Ned Tijdschr Geneeskd 2000;144(47):2243-7.
3. Aggarwal P, Wali JP, Singh S, et al. A clinico-bacteriological study of peripheral tuberculous lymphadenitis. J Assoc Physicians India 2001;49:808-12.
4. Nataraj G, Kurup S, Pandit A, et al. Correlation of fine needle aspiration cytology, smear and culture in tuberculous lymphadenitis:a prospective study. J Postgrad Med 2002;48(2):113-6.
5. Lakhey M, Bhatta CP, Mishra S. Diagnosis of tubercular lymphadenopathy by fine needle aspiration cytology, acid-fast staining and mantoux test. JNMA Nepal Med Assoc 2009;48(175):230-3.
6. Asimacopoulos EP, Berry M, Garfield B, et al. The diagnosis efficacy of fine-needle aspiration using cytology and culture in tuberculous lymphadenitis. Int J Tuberc Lung Dis 2010;14(1):93-8.
7. Fontanilla JM, Bornes A, von Reyn CF. Current Diagnosis and Management of Peripheral Tuberculous Lymphadenitis. Clin Infect Dis 2011;53(6):555-62.
8. Nidhi P, Sapna T, Shalini M, et al. FNAC in tuberculous lymphadenitis:Experience from a tertiary level referral centre. Indian J Tuberc 2011;58:102-7.
9. Asano S. Granulomatous lymphadenitis. J Clin Exp Hematop 2012;52(1):1-16.
10. Knox J, Lane G, Wong JS, et al. Diagnosis of tuberculous lymphadenitis using fine needle aspiration biopsy. Intern Med J 2012;42(9):1029-36.
11. Fanny ML, Beyam N, Gody JC, et al. Fine-needle aspiration for diagnosis of tuberculous lymphadenitis in children in Bangui, Central African Republic. BMC Pediatr 2012;12:191.
Downloads
Published
How to Cite
Issue
Section
License
ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
