dc.contributor.author | Helle, Ole Magnus Bjørgaas | |
dc.contributor.author | Kanthali, Mala | |
dc.contributor.author | Akhtar, Naish | |
dc.contributor.author | Purohit, Manju | |
dc.contributor.author | Mustafa, Tehmina | |
dc.date.accessioned | 2024-02-01T13:26:54Z | |
dc.date.available | 2024-02-01T13:26:54Z | |
dc.date.created | 2023-06-20T10:33:45Z | |
dc.date.issued | 2023 | |
dc.identifier.issn | 8755-1039 | |
dc.identifier.uri | https://hdl.handle.net/11250/3115078 | |
dc.description.abstract | Background
Fine needle aspiration cytology (FNAC) is established as a first line investigation for tuberculous lymphadenitis (TBLA). We aimed to describe the various cytomorphologic features of tuberculosis (TB) on FNAC and their contribution in the diagnostic decision-making in suspected TBLA cases.
Methods
Patients with presumptive TBLA were prospectively enrolled (n = 266) and subjected to routine diagnostic work-up for TB, including FNAC samples, and followed until the end of treatment. Patients were categorized as TB or non-TB cases based on a composite reference standard of which the various cytomorphologic patterns were compared. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy was calculated using cross-tabulation.
Results
Fifty-six patients were categorized as bacteriologically confirmed TB, 102 as clinically confirmed TB and 108 as non-TB. The most common cytomorphologic pattern among TB cases (59%) was granulomatous inflammation with necrosis, however, about one-third of tuberculous lymphadenitis patients presented with non-granulomatous inflammation, with 21% showing only necrosis and 13% presenting with a reactive pattern. The overall sensitivity and specificity of FNAC was 85% and 66%, respectively.
Conclusions
We found that about one-third of TBLA patients presented without granulomas on FNA, highlighting the importance of considering TB in a wide spectrum of cytomorphology in a high TB burden setting. Our study supports the use of FNAC as a first-line investigation tool for diagnosing TBLA in a low-resource setting due to its relative simplicity and good sensitivity. However, the low specificity of FNAC, emphasizes the need for a second-tier confirmatory test with improved specificity. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Wiley | en_US |
dc.rights | Navngivelse 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/deed.no | * |
dc.title | Significance of non-granulomatous cytomorphology on fine needle aspirate in lymphadenitis cases classified as tuberculous by using a composite reference standard | en_US |
dc.type | Journal article | en_US |
dc.type | Peer reviewed | en_US |
dc.description.version | publishedVersion | en_US |
dc.rights.holder | Copyright 2023 The Author(s) | en_US |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |
dc.identifier.doi | 10.1002/dc.25167 | |
dc.identifier.cristin | 2156101 | |
dc.source.journal | Diagnostic Cytopathology | en_US |
dc.source.pagenumber | 575-583 | en_US |
dc.identifier.citation | Diagnostic Cytopathology. 2023, 51 (9), 575-583. | en_US |
dc.source.volume | 51 | en_US |
dc.source.issue | 9 | en_US |