Mahana Sonam, Tomar Reena, Agrawal Rawi, Saksena Rushika, Manchanda Vikas, Gupta Ruchika
Address: Department of Pathology, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
Department of Microbiology, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
Cytojournal. 2016 Jul 27;13:17. doi: 10.4103/1742-6413.187070. eCollection 2016.
To evaluate and compare the role of Ziehl-Neelsen (ZN) staining and mycobacterial culture in diagnosis of tuberculous lymphadenitis.
A total of 56 fine needle aspirations (FNAs) from patients who were clinically suspected to have tuberculous lymphadenitis were included. Acid-fast Bacilli detection was attempted by ZN staining on smears as well as culture on Middlebrook 7H9 broth. Percentage positivity of both smears and culture was calculated.
Of the 56 cases, 46 showed cytomorphological features consistent with tuberculosis (TB). The most common pattern was only necrosis in 37 cases followed by necrotizing granulomas in 13 cases. ZN-stained smears were positive in 40 cases while culture was positive in only 27 cases. The highest smear and culture positivity was noted in cases with only necrosis. In six cases, diagnosis of TB was made on culture alone since smear was negative in these cases.
FNA is a reliable technique for early and accurate diagnosis of tuberculous lymphadenitis in many cases. Mycobacterial culture by newer rapid techniques can assist in bacillary detection in smear-negative cases and also allows for drug sensitivity testing. Hence, culture should be resorted to in such cases.
评估并比较萋-尼（ZN）染色和分枝杆菌培养在结核性淋巴结炎诊断中的作用。
纳入56例临床疑似结核性淋巴结炎患者的细针穿刺抽吸物（FNA）。通过涂片ZN染色及在Middlebrook 7H9肉汤培养基上培养来检测抗酸杆菌。计算涂片和培养的阳性率。
56例中，46例显示出与结核病（TB）一致的细胞形态学特征。最常见的模式是仅37例出现坏死，其次是13例出现坏死性肉芽肿。ZN染色涂片40例阳性，而培养仅27例阳性。仅坏死的病例涂片和培养阳性率最高。6例中，因涂片阴性仅通过培养确诊为TB。
FNA在许多情况下是早期准确诊断结核性淋巴结炎的可靠技术。采用更新的快速技术进行分枝杆菌培养有助于涂片阴性病例的杆菌检测，还能进行药敏试验。因此，此类病例应采用培养方法。
