Subclassification of localized Leishmania lymphadenitis in fine needle aspiration smears

OBJECTIVE: To describe the cytologic findings of localized Leishmania lymph adenitis and discuss the differential diagnosis. STUDY DESIGN: The study group consisted of 133 cases. All of them were diag nosed by fine needle aspiration (FNA) study. The ages ranged between 3 and 80 years, 102 were male and 31 female. Seventy lymph nodes were excised. RESULTS: The FNA smears revealed a polymorphic population of cells composed of lymphocytes, histiocytes, giant cells, abnormal plasma cells and tingib le body macrophages. Leishman-Donovan (LD) bodies were identified in al cas es, but their number differed from case to case. Granulomas, dendritic cell s, mast cells and lymphoglandular bodies were identified in a substantial n umber of cases. Depending upon the presence of characteristics cytologic fi ndings, the cases were divided into five major groups: acute inflammation w ith giant cells, histiocytic granulomas, epithelioid cell granulomas, plasm a cell type and mixed histioplasmacytic type. CONCLUSIONS: Leishmania is an uncommon cause of cervical lymphadenitis but should be considered in the differential diagnosis of unexplained lymphaden opathy in endemic countries. Demonstration of LD bodies is necessary for th e diagnosis of this self-limited condition, for which no treatment is requi red.