CYTODIAGNOSIS OF TUBERCULOUS LYMPHADENITIS - A CORRELATIVE STUDY WITHMICROBIOLOGIC EXAMINATION

One hundred two of 272 cases of cytodiagnosis of tuberculous lymphaden itis were subjected to mycobacterial examination by Ziehl-Neelsen stai ning on direct and concentration smears and by culture. Cytomorphologi cally the cases were categorized into four types: 1, predominantly nec rotic material; 2, typical caseating epithelioid cell granulomas and g iant cell formation; 3, only noncaseating epithelioid cell granulomas with or without giant cells; and 4, doubtful presence of epithelioid c ells. Ziehl-Neelsen staining for acid-fast bacilli (AFB) was positive in 25% in direct smears, 26.5% in concentration smears and 29.5% in bo th combined. The cultures for mycobacteria were positive in 49%; combi ned smear and culture positivity was found in 56.9%. Maximum culture p ositivity was seen in cases with type 1 smears (56.9%) followed by typ es 2 (44%) and 3 (40%). The percentage of AFB positivity was similar i n type 1 and type 2 smears (32.2% and 30%, respectively); however, AFB were present in large numbers in type 1 smears as compared to type 2 and 3 smears. In type 3 smears AFB positivity was found in 20% of case s. Cases with type 4 smears were negative for AFB in smears and cultur e. In eight cases (7.8%) the smears were positive for AFB, whereas the cultures were negative, indicating that negative culture examination still does not exclude the possibility of tuberculosis. However, cultu re is essential to a characterization and determination of drug sensit ivity.