ABSTRACT
Introduction: Peripheral lymhadenopathy is common presentation of inflammatory and neoplastic lesions.FNAC is one of the first–line investigations of managenent for the evaluation of lymphadenopathy.Enlargement of Lymph node is seen in variety of reactive inflammatory to neoplastic conditions related to regional or systemic diseases. It is very useful, easy, rapid, minimal invasive, cost effective and accurate approach in diagnosing various lymph node lesions and helpful in the workup of management of patients with nodal enlargement. Methods: A total of 175 patients were included in our study Department of Pathology, referred from the department of ENT, Medicine, Paediatrics, Surgery, Respiratory Medicine and Tuberculosis of Karpaga Vinayaga Hospital in the period from January 2017 to Dec 2018. Alcohol fixed and air dry smears were prepared and stain with H&E, PAP, and MGG. The special stain like PAS, ZN (20%) etc were done whenever required. Results:In present study total 175 cases of lymphadenopathy were studied. The presentation of various lymph node lesions on cytomorphological findings were Acute non–specific lymphadenitis cases were 5 (2.85%), Chronic non–specific lymphadenitis cases were 11 (8.28%), Granulomatous lymphadenopathy cases were 6 (3.42%), Tuberculous lymphadenitis cases were 60 (34.28%)’ Reactive lymphadenitis cases were 48 (27.42%), Metastasis to lymph node cases was 36 (20.57%), Lymphoma cases were 9 (5.14%). Unsatisfactory smears(11) were excluded from the study. The detailed clinical material data, relevant investigations were taken for supporting the diagnosis. Conclusion: Cytomorphological features of lymph node FNAC, used in conjunction with clinical details, laboratory test investigations, radiology imaging study will be very helpful for diagnosing various disorders. It will be rapid, cost effective, safe, and reliable method for early diagnosis and treatment of the patients
ABSTRACT
La tuberculosis extrapulmonar representa el 1520 % de todas las formas de presentación. La tuberculosis ganglionar periférica es la segunda forma extrapulmonar más frecuente en niños de Argentina, luego de la pleural. En el Servicio de Tisiología del Hospital de Niños "Dr. Ricardo Gutiérrez", se analizaron en forma retrospectiva 92 casos de tuberculosis ganglionar periférica asistidos entre agosto, 2000-septiembre, 2015. La edad media fue 8,7 ± 5 años. Las adenopatías fueron periféricas únicas (31,5 %), periféricas múltiples (20,6 %) y periféricas asociadas a profundas (47,8 %). Predominó la localización cervical (80 %). El 80 % recibió antibioticoterapia previa, sin respuesta. El 56 % tenía foco de contagio conocido; 69 %, prueba cutánea de tuberculina positiva y 54 %, radiografía de tórax patológica. Todos iniciaron tratamiento antifímico por clínica compatible, exposición y/o prueba cutánea de tuberculina positiva, antes de la confirmación microbiológica o histológica. La evolución fue curación (81,5 %), derivación cercana al domicilio (8,7 %), abandono (8,7 %). Un paciente falleció.
Extrapulmonary tuberculosis accounts for 15-20 % of all clinical presentations of tuberculosis. Peripheral tuberculous lymphadenitis is the second most common presentation of extrapulmonary tuberculosis in children, after pleural tuberculosis, in Argentina. We analyzed 92 patients with peripheral tuberculous lymphadenitis seen at the Department of Tisiology of Hospital de Niños "Dr. Ricardo Gutiérrez" between August 2000 and September 2015. The patients' mean age was 8.7 ± 5 years. Nodal sites corresponded to single peripheral (31.5 %), multiple peripheral (20.6 %), and peripheral associated with deep nodes (47.8 %). Cervical lymph nodes were the most common site of involvement (80 %). In 80 % of patients previous antibiotic therapy had been administered, without response. The tuberculosis source was known in 56 %; 69 % had a positive tuberculin skin test; and 54 %, a pathological chest X-ray. Tuberculosis treatment was started on all patients based on clinical criteria, exposure and/or positive tuberculin skin test, prior to microbiological or histological confirmation. The clinical course was either healing (81.5 %), referral to a facility near home (8.7 %) or dropout (8.7 %). One patient died.