Subharti Medical College, Swami Vivekanand Subharti University Meerut, India.
Department of Pathology, Subharti Medical College, Swami Vivekanand Subharti University, Meerut, India.
Indian J Tuberc. 2020 Oct;67(4):495-501. doi: 10.1016/j.ijtb.2020.07.001. Epub 2020 Jul 13.
The spectrum of morphological pattern in tubercular lymphandenopathies was observed to study the various cytomorphological patterns and their correlation with acid fast bacilli.
FNAC smears of 210 cases of granulomatous lymphadenitis stained with Giemsa, Pap and haematoxylin and eosin were used to analyze cytomorphological pattern and Zeihl Neelsen stained smears for acid fast bacilli (AFB) detection.
193 cases with necrotising granulomatous inflammation or positive acid fast bacilli were included. Age group 21-30 years was most common (38.3%) followed by age group 11-20 years (30.05%). Females constituted 66.3% of patients and 33.7% were male. Overall the most common pattern in present study was pattern A (Epitheloid granuloma with caseous necrosis 33.7% followed by pattern B (caseous necrosis with few scattered epitheloid histiocytes and lymphocytes) 31.1% and pattern C (caseous necrosis with suppurative inflammation) 30.6%, followed by pattern D (Caseous necrosis only) (3.6%) and pattern E (non necrotising epitheloid granuloma with positive acid fast bacilli) (1.03%). Acid fast bacilli were demonstrable in 175 cases (90.7%). Amongst the acid fast bacilli positive cases highest bacillary load 3+ grade was seen in pattern C in 6/59 (10.16%) cases.
FNAC is a simple useful tool and should be attempted in all cases of lymphandenopathies. It helps in establishing a diagnosis of tubercular etiology based on its morphological patterns however demonstration of acid fast bacilli on aspirated material confirms the diagnosis.
观察结核性淋巴结病的形态学模式谱，研究各种细胞形态学模式及其与抗酸杆菌的相关性。
用革兰氏染色、巴氏染色和苏木精-伊红染色对 210 例肉芽肿性淋巴结炎的细针穿刺抽吸物进行细胞学检查，分析细胞形态学模式，并对 Zeihl-Neelsen 染色的抗酸杆菌（AFB）检测涂片进行染色。
纳入了 193 例伴有坏死性肉芽肿性炎症或抗酸杆菌阳性的病例。年龄在 21-30 岁的患者最常见（38.3%），其次是年龄在 11-20 岁的患者（30.05%）。女性患者占 66.3%，男性患者占 33.7%。本研究中最常见的模式是 A 型（上皮样肉芽肿伴干酪样坏死，占 33.7%），其次是 B 型（干酪样坏死伴少数散在的上皮样组织细胞和淋巴细胞，占 31.1%）和 C 型（干酪样坏死伴化脓性炎症，占 30.6%），其次是 D 型（干酪样坏死仅，占 3.6%）和 E 型（非坏死性上皮样肉芽肿伴抗酸杆菌阳性，占 1.03%）。175 例（90.7%）可检测到抗酸杆菌。在抗酸杆菌阳性的病例中，C 型的菌载量最高为 3+级，占 59 例中的 6 例（10.16%）。
FNAC 是一种简单而有用的工具，应在所有淋巴结病的病例中尝试。它可以帮助根据其形态学模式确立结核病因的诊断，但在抽吸物中显示抗酸杆菌可确认诊断。
