Volume : 7, Issue : 1, January - 2018

Evaluation of Fine Needle Aspiration Cytology (FNAC) by using Ziehl-Neelsen (ZN) stain for the diagnosis of extra pulmonary tuberculosis in a teaching hospital of rural setup

Dr. Balaji Chowdari, Dr. Krishna Prasad Padagala

Abstract :

<p>&nbsp;</p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;line-height:200%"><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">BACKGROUND</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">: Tuberculosis is one of most common infectious diseases in India, which is causing economic burden <span style="mso-spacerun:yes">&nbsp;</span>despite being easy in<span style="mso-spacerun:yes">&nbsp; </span>diagnosis and treatment. India has the highest burden of tuberculosis according to WHO, 2017 estimates (<span style="background:white">2.79 million</span></span><span lang="EN-IN" style="font-size:10.5pt;line-height:200%;font-family:&quot;Trebuchet MS&quot;,&quot;sans-serif&quot;;&#10;color:#444444;background:white"> </span><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">out of <span style="background:white">10.4 million</span> world wide).<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;line-height:200%"><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">PATIENTS AND METHODS</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:&#10;200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">: Fine needle aspiration cytology for peripheral lymphadenopathy, east lesions, thyroid lesions and superficial swellings were done<span style="mso-spacerun:yes">&nbsp; </span>using <span style="color:#222222;background:white;mso-bidi-font-weight:bold">Ziehl</span><span style="color:#222222;background:white">&ndash;<span style="mso-bidi-font-weight:bold">Neelsen</span></span> (ZN) stain for a period of one year <span style="mso-spacerun:yes">&nbsp;</span>between March 2016 to Feuary 2017 in the department of Pathology. <o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;line-height:200%"><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">RESULTS</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">: Out of 132 cases 21.21%<span style="mso-spacerun:yes">&nbsp; </span>showed<span style="mso-spacerun:yes">&nbsp; </span>positive for acid fast bacilli. Lymphnodes constitute majority of the cases followed by Breast abscess. <o:p></o:p></span></p> <p class="Default" style="text-align:justify;line-height:200%"><b style="mso-bidi-font-weight:normal"><span lang="EN-IN">CONCLUSION</span></b><span lang="EN-IN">: ZN stain plays a major role in confirming the diagnosis of extra pulmonary tuberculosis. Thus recommending implementation of mandatory ZN staining for all the FNAC cases for better and confirmed diagnosis of extra pulmonary tuberculosis cases and also provides a ready reference <span style="mso-spacerun:yes">&nbsp;</span>to decide whether the sample has to be sent for testing MDR TB.<span style="mso-spacerun:yes">&nbsp; </span><o:p></o:p></span></p>