Citología neural por aspiración con aguja (fnac) en lepra

La lepra es, sobre todo, una enfermedad de los nervios periféricos y se requiere una técnica más sencilla que la biopsia neural para evaluar el compromiso neural, especialmente en lepra neurítica pura (PN). Este trabajo fue diseñado para evaluar el papel de la FNAC en el diagnóstico y clasificación de la lepra. Se efectuó un estudio prospectivo en 25 pacientes con lepra clínicamente activa y al menos un nervio periférico sensitivo engrosado. Los aspirados neurales se evalúan por May-Grunwald-Giemsa y tinción Fite. Se realizan tests de la lepromina, frotis cutáneos (SSS), y biopsias cutáneas (excepto en casos PN) y biopsias neurales y con FNAC. El FNAC neural en 23 casos (92 por ciento) proporciona aspirados y se comparan con valor diagnóstico. Basados en estos resultados, se desarrolló un criterio citológico para la interpretación de aspirados neurales y los casos se clasifican como paucibacilares (18), BB (2), BL(2), LL (l) y no diagnósticos (2). Todos los casos PN en lepra son comparables con la patología neural y el criterio citologico propuesto puede ser útil en la clasificiación de los aspirados neurales (AU)

Is fine needle aspiration cytology a useful tool for the diagnosis of tuberculous lymphadenitis?

OBJECTIVE: To study the role of fine needle aspiration cytology (FNAC) in the diagnosis of tuberculous lymphadenitis and find a place for FNAC as laboratory diagnostic method in tuberculosis (TB) control programmes. DESIGN: Prospective laboratory study. METHOD: Duplicate smears from 127 lymph node aspiration were prepared. Both slides were air-dried. Giemsa stain for cytological examination and Ziehl-Neelsen stain for demonstration of acid fast bacillus(AFB) were used and examined by a pathologist and laboratory technologist respectively. SETTING: Tigrai Regional Health Research and Laboratory Centre which is the only unit with microbiological and cytopathological service in the region. SUBJECTS: Patients with one or more enlarged lymph nodes who were sent for FNAC were included. RESULTS: The AFB positivity among the cytologically diagnosed cases of TB lymphadenitis was 56.77%. If we had used culture media for Mycobacterium spp, the positivity would have probably been higher. The positivity rate varied depending on the type of the aspirate. Caseous aspirate showed a higher positivity rate of 60.47% whereas no AFBs were detected in haemorrhagic aspirates. CONCLUSION: This study has demonstrated the usefulness of FNAC in the diagnosis of TB lymphadenitis and the national TB and leprosy control programmes should encompass FNAC as a diagnostic means instead of biopsy which is more invasive and costly.

Cytological needle aspiration of the nerve for the diagnosis of pure neural leprosy.

Pure neural (also called primary neuritic) leprosy manifests itself by involvement of only the nerve in the absence of skin lesions. Therefore, it sometimes can pose a diagnostic problem. Cytological needle aspiration of an affected nerve can be a valuable tool under such circumstances. The method as developed at Anandaban Leprosy Hospital, Nepal, is described and two cases are presented.

Fine needle aspiration of lymph nodes in leprosy. A study of bacteriologic and morphologic indices.

Lymph node aspiration was performed from the inguinal group of lymph nodes in 16 patients having lepromatous or borderline leprosy. In the same group of patients impression smears of excised lymph node and slit smears of the skin were also studied. This study made it obvious that the aspiration biopsy technic gave similar information regarding the Bacteriologic (BI) and Morphologic Indices (MI) as the impression smears of excised lymph nodes. The technic of aspiration being simple and nontraumatic is recommended for the follow-up of patients on antileprosy drugs and in reactional phases.