Impact of fine needle aspiration cytology strategy implemented at the microscopy center level for diagnosis of tuberculous lymphadenitis

Impact of Fine Needle Aspiration Cytology Strategy for Diagnosis of Tuberculous Lymphadenitis

Introduction

In India, tuberculosis (TB) is a significant concern, particularly in individuals with HIV/AIDS. Extrapulmonary TB (EPTB) accounts for about 50% of TB cases, with tuberculous lymphadenitis being the most common form, representing around 35% of EPTB cases. Fine needle aspiration cytology (FNAC) has shown to be highly accurate in diagnosing tuberculous lymphadenitis, with 83-94% accuracy.

Methods

This study was a randomized cluster trial with one control and one intervention arm. At the intervention units (DMCs), suspected tuberculous lymphadenitis cases underwent FNAC of the suspected superficial lymph nodes by trained Medical Officers. The control group did not receive this intervention. The effectiveness and feasibility of the FNAC strategy were assessed in the intervention group.

Results

At the intervention DMCs, FNAC was performed on 1298 suspected cases of Tuberculous Lymphadenitis. The time intervals between advice of FNAC and performance of FNAC, as well as the start of therapy, were significantly reduced in the intervention arm. Complications were insignificant, and there was a high level of agreement between FNAC reports generated at the DMCs and that at Medical College.

Conclusion

Implementation of FNAC strategy at the DMC level for detection of tuberculous lymphadenitis cases was found to be feasible and effective.

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