细针穿刺细胞学检查在结核性颈淋巴结炎诊断中的效能

Efficacy of Fine-Needle Aspiration Cytology in the Diagnosis of Tuberculous Cervical Lymphadenitis.

作者信息

Rammeh Soumaya, Romdhane Emna, Arfaoui Toumi Amira, Houcine Yoldez, Lahiani Rym, Sassi Asma, Mardassi Helmi, Ben Salah Mamia, Ferjaoui Mohamed

机构信息

Department of Pathology, Charles Nicolle Hospital, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.

Department of E.N.T, Charles Nicolle Hospital, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.

出版信息

Acta Cytol. 2018;62(2):99-103. doi: 10.1159/000487503. Epub 2018 Mar 27.

DOI:10.1159/000487503

PMID:29587250

Abstract

OBJECTIVE

This study assesses the role of fine-needle aspiration cytology (FNAC) in the diagnosis of tuberculous lymphadenitis (TL) in comparison with histology and bacteriology findings.

STUDY DESIGN

We undertook a descriptive retrospective study of 937 FNAC specimens from 851 patients with cervical lymph nodes. The FNAC findings were then compared to histopathology and bacteriology.

RESULTS

Of the 937 aspirates, the cytopathological diagnoses consisted of 426 (55.9%) TL, 185 (24.3%) reactive lymphoid hyperplasia, 18 (2.3%) suppurative inflammation, 78 (10.2%) malignant metastatic tumor, and 54 (7%) lymphoma. Of the 426 TL cases, 171 were diagnosed by FNAC combined with bacteriological examination. In this group, 22 cases were found to be positive on Ziehl-Neelsen stain and 16 by culture. A histopathology report was available for 62 cases. Compared to histopathology, the overall diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FNAC in the diagnosis of cervical TL were, respectively, 96.77, 100, 100, and 96.67%. When comparing bacteriology to histopathology, these values were 97.44, 100, 100, and 91.67%.

CONCLUSION

Our study shows that FNAC is a sensitive and specific tool for the diagnosis of cervical TL.

摘要

目的

本研究旨在评估细针穿刺细胞学检查（FNAC）在结核性淋巴结炎（TL）诊断中的作用，并与组织学和细菌学检查结果进行比较。

研究设计

我们对851例颈部淋巴结患者的937份FNAC标本进行了描述性回顾性研究。然后将FNAC检查结果与组织病理学和细菌学检查结果进行比较。

结果

在937份穿刺物中，细胞病理学诊断包括426例（55.9%）TL、185例（24.3%）反应性淋巴组织增生、18例（2.3%）化脓性炎症、78例（10.2%）恶性转移性肿瘤和54例（7%）淋巴瘤。在426例TL病例中，171例通过FNAC联合细菌学检查确诊。在该组中，22例齐-尼氏染色呈阳性，16例培养阳性。有62例获得了组织病理学报告。与组织病理学相比，FNAC诊断颈部TL的总体诊断敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为96.77%、100%、100%和96.67%。将细菌学检查结果与组织病理学检查结果进行比较时，这些值分别为97.44%、100%、100%和91.67%。