COMPARISON OF FINE NEEDLE ASPIRATION CYTOLOGY WITH HISTOPATHOLOGY IN DETECTING TUBERCULOSIS IN CERVICAL LYMPHADENOPATHY
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Abstract
Objective: To evaluate the sensitivity and specificity of Fine Needle Aspiration Cytology (FNAC) in diagnosing tuberculosis
lymphadenitis and to compare FNAC to histopathology of incisional biopsy of the cervical lymph nodes in the same subjects.
Material and Methods: It was a Comparative study conducted in the departments Histopathology of Khyber Teaching hospital and Khyber Medical College, Peshawar, Pakistan. The study period was from January 2013 to January 2014. Our study included 100 patients, clinically suspected to have tuberculous lymphadenitis. The patients of all ages and both sexes who were clinically suspected to have tuberculous lymphadenitis underwent FNAC followed by incisional biopsy to confirm the diagnosis. The relevant laboratory investigations were also recorded in these patients.
Results: In this study, the sensitivity was 95%, specificity was 50%, Positive Predictive Value (PPV) was 91% & Neative Predictive Value (NPV) was 63%. The false negative (FN) rate was 4% and false positive (FP) rate was 8%. The true positive (TP) rate was 81% & true negative (TN) rate was 7%. The inadequate rate was 3%.
Conclusion: The sensitivity and Positive Predictive Value (PPV) is high while specificity and Negative Predictive Value (NPV) is low. Therefore FNAC is a useful screening test however due to low specificity it must be combined with AFB staining or PCR in cases where there is high suspicion of false positive cases. In case of inconclusive results on cytology in patients with a high clinical suspicion of tuberculosis the results must be confirmed by Incisional biopsy.
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