Role of Fine Needle Aspiration Cytology in Effective Management of Patients with Granulomatous Inflammation in Neoplastic and Non-Neoplastic Lesions

  • Dr. Drashti Patel Senior Resident, Department of Pathology, Surat Municipal Instbitute of Medical Education and Research, Surat, Gujrat, India
  • Dr. Ashwini Shukla Professor (Additional), Department of Pathology, Surat Municipal Institute of Medical Education and Research, Surat, Gujrat, India
  • Dr. Toral Jivani Assistant Professor, Department of Pathology, Surat Municipal Institute of Medical Education and Research, Surat, Gujrat, India
Keywords: Fine needle aspiration cytology, Granuloma, PAS stain, Tuberculosis, ZN Stain

Abstract

Background: Granulomatous inflammation is a common diagnosis given in fine-needle aspiration cytology (FNAC) and it is a type of chronic inflammation in which tissue reaction appears following cell injury.

Aims: To assess the usefulness of the cytological study in the diagnosis of granulomatous lesions.

Materials and Methods: An observational study is done based on cytomorphological evaluation of 156 cases of granulomatous inflammation diagnosed at the Department of Pathology, in Surat Municipal Institute of Medical Education & Research over 18 months from February 2018 to July 2019.

Results: Out of the total of 156 cases of granulomatous inflammation, tuberculosis was the most common finding in 111 cases (71.15%), followed by fungal infection (05 cases). The male to female ratio was 1.0 to 1.4. The most commonly affected age group was 21 to 30 years.

Conclusions: All the cases of granulomatous inflammations are analysed for definitive diagnosis to provide early and proper treatment of underlying diseases, malignancies or lymphoma.

Downloads

Download data is not yet available.

References

Shah KK, Pritt BS, Alexander MP. Histopathologic review of granulomatous inflammation. J Clin Tuberc Other Mycobact Dis. 2017 Feb 10;7:1-12. doi: 10.1016/j.jctube.2017.02.001.

World Health Organization (WHO), “Tuberculosis Fact Global and Regional Incidence,” 1992; Sheet No. 104-2006.

Singh S, Dey B, Sachdeva KS, Kabra SK, Chopra KK, Chaudhary VK, Sharma P, Katoch VM. Challenges in tuberculosis diagnosis and management: recommendations of the expert panel. J Lab Physicians. 2015 Jan-Jun;7(1):1-3. doi: 10.4103/0974-2727.154778.

Mittal P, Handa U, Mohan H, Gupta V. Comparative evaluation of fine needle aspiration cytology, culture, and PCR in diagnosis of tuberculous lymphadenitis. Diagn Cytopathol. 2011 Nov;39(11):822-6. doi: 10.1002/dc.21472.

Nur, Tamanna E, Afroz Shirin, and Moni Mohan Saha. "Diagnostic Accuracy of Fine Needle Aspiration Cytology in Diagnosis of Tuberculous Lymphadenitis." Journal of Enam Medical College 9.1 (2019): 30-33.

Gregorie hb jr, othersen hb jr, moore mp Jr. The significance of sarcoid-like lesions in association with malignant neoplasms. Am J Surg. 1962 Oct;104:577-86. doi: 10.1016/0002-9610(62)90399-9. PMID: 13901642.

Oberman HA. Invasive carcinoma of the breast with granulomatous response. Am J Clin Pathol. 1987 Dec;88(6):718-21. doi: 10.1093/ajcp/88.6.718.

Gorton g, linell f. Malignant tumours and sarcoid reactions in regional lymph nodes. Acta radiol. 1957 May;47(5):381-92. doi: 10.3109/00016925709170911.

Hollingsworth HC, Longo DL, Jaffe ES. Small noncleaved cell lymphoma associated with florid epithelioid granulomatous response. A clinicopathologic study of seven patients. Am J Surg Pathol. 1993 Jan;17(1):51-9. doi: 10.1097/00000478-199301000-00006.

National tuberculosis centre Annual report of national tuberculosis control progrmme. Ministry of Health, Kathmandu, Nepal 2015/2016.

Narayana Reddy RA, Narayana SM, Shariff S. Role of fine-needle aspiration cytology and fluid cytology in extra-pulmonary tuberculosis. Diagn Cytopathol. 2013 May;41(5):392-8. doi: 10.1002/dc.22827.

Ergete, Wondwossen, and Alemayehu Bekele. "Acid fast bacilli in aspiration smears from tuberculous patients." Ethiopian Journal of Health Development 14.1 (2000): 99-104.

Permi, H. S., Padma, S. K., Teerthanath, S., Mathias, M., Kumar, S., & HL, K. P. (2012). A histopathological study of granulomatous inflammation. Journal of Health and Allied Sciences NU, 2(01), 15-19.

Pawale, Jayashree, Rekha Puranik, and M. H. Kulkarni. "A histopathological study of granulomatous inflammations with an attempt to find the aetiology." J Clin Diagn Res 5.2 (2011): 301-6.

Nidhi P, Sapna T, Shalini M, Kumud G. FNAC in tuberculous lymphadenitis: experience from a tertiary level referral centre. Indian J Tuberc. 2011 Jul;58(3):102-7.

Khajuria, R., Goswami, K. C., Singh, K., & Dubey, V. K. (2006). Pattern of lymphadenopathy on fine needle aspiration cytology in Jammu. JK Sci, 8(3), 157-159.

Koo V, Lioe TF, Spence RA. Fine needle aspiration cytology (FNAC) in the diagnosis of granulomatous lymphadenitis. Ulster Med J. 2006 Jan;75(1):59-64.

Adhikari, R. C., K. B. Shrestha, and G. Sayami. "Granulomatous inflammation: a histopathological study." Journal of Pathology of Nepal 3.6 (2013): 464-468.

Majeed MM, Bukhari MH. Evaluation for granulomatous inflammation on fine needle aspiration cytology using special stains. Patholog Res Int. 2011;2011:851524. doi: 10.4061/2011/851524.

Sandhu VK, Sharma U, Singh N, Puri A. Cytological spectrum of salivary gland lesions and their correlation with epidemiological parameters. J Oral Maxillofac Pathol. 2017 May-Aug;21(2):203-210. doi: 10.4103/jomfp.JOMFP_61_17.

Panicker, N. K., Buch, A. C., Vimal, S., & Dharwadkar, A. P. (2012). Cytological diagnosis of microfilariae in subcutaneous nodule. Medical Journal of Dr. DY Patil University, 5(1), 71.

Dayal, Achaleshwar, and Karthikeyan Selvaraju. "Filariasis of the breast." (2010).

Kushwah, Akanksha, Narendra Bhattarai, and Ajay Koirala. "A histopathological study of granulomatous lesions." Journal of Pathology of Nepal 8.2 (2018): 1341-1345.

Sehgal, S., Goyal, P., Ghosh, S., Mittal, D., & Singh, S. (2014). Malignancy and granulomatosis: causality or coincidence? Narrative systematic review. Iranian Journal of Pathology, 9(4), 237-244.

Khurana KK, Stanley MW, Powers CN, Pitman MB. Aspiration cytology of malignant neoplasms associated with granulomas and granuloma-like features: diagnostic dilemmas. Cancer. 1998 Apr 25;84(2):84-91. doi: 10.1002/(sici)1097-0142(19980425)84:2<84::aid-cncr3>3.0.co;2-d.

Krishnaswamy, H., and C. K. Job. "The role of Ziehl Neelsen and Fluorescent stains in tissue sections in the diagnosis of tuberculosis." Indian Journal of Tuberculosis 21.10 (1974): 18-21.

Das DK, Pant CS, Pant JN, Sodhani P. Transthoracic (percutaneous) fine needle aspiration cytology diagnosis of pulmonary tuberculosis. Tuber Lung Dis. 1995 Feb;76(1):84-9. doi: 10.1016/0962-8479(95)90586-3.

Bezabih M, Mariam DW, Selassie SG. Fine needle aspiration cytology of suspected tuberculous lymphadenitis. Cytopathology. 2002 Oct;13(5):284-90. doi: 10.1046/j.1365-2303.2002.00418.x.

CITATION
DOI: 10.17511/jopm.2021.i03.06
Published: 2021-06-30
How to Cite
Dr. Drashti Patel, Dr. Ashwini Shukla, & Dr. Toral Jivani. (2021). Role of Fine Needle Aspiration Cytology in Effective Management of Patients with Granulomatous Inflammation in Neoplastic and Non-Neoplastic Lesions. Tropical Journal of Pathology and Microbiology, 7(3), 128-134. https://doi.org/10.17511/jopm.2021.i03.06
Section
Original Article