Ghulam Rasool, Usman Ali, Farman Ali, Nadia Naseem, A.H Nagi


Background: Tuberculous lymphadenitis is a common form of extrapulmonary tuberculosis in young adults and children which commonly involves superficial lymph nodes. The purpose of this study was to detect and confirm the presence of acid fast bacilli in lymph node biopsies using routine Ziehl Neelsen stain, Kinyoun stain and fluorescence staining and also to determine the best, rapid and more cost effective technique of staining for the detection of acid fast bacilli.
Material & Methods: This descriptive cross-sectional study was conducted in University of Health Sciences, Lahore, Punjab, Pakistan, from November, 2013 to February 2014. Sample size was 97 patients with lymph node biopsies taken from through non probability, consecutive sampling technique. Demographic variables were; gender, age group. Research variables were; site of lymph node biopsy, type of granulomatous inflammation, positivity of AFB. The attributes of age group were; 1-15. 16-30, 31-45 and 46-75. The attributes of site of lymph node biopsy were; supra-clavicular, cervical, axillary, right mediastinal and submandibular. The attributes of type of granulomatous inflammation were; caseous and non-caseous and of positivity of AFB were; positive and negative. Data was collected in Gulab Devi Chest Hospital, Lahore. Lymph node biopsies from different sites. including supraclavicular, cervical, axillary, right mediastinal and Submandibular were included and stained with. Descriptive analysis was done.
Results: Out of a total of 97 patients with granulomatous lymph node biopsies, 36 (37%) were males and 61 (63%) females. Caseous granulomas were 67(69%), while 30(31%) showed non-caseous granulomas. Lymph nodes were collected from different sites e.g. supraclavicular (20, 21%), cervical (69, 71%), axillary (4, 4%), right mediastinal (2, 2%) and Submandibular (2, 2%) lymph nodes. AFB were microscopically positive in 54 (56%) nodal tissue biopsy sections and forty three (44%) cases were negative. From a total of 54 positive cases routine ZN stain was positive in 45 (46%), Kinyoun stain was positive in 54 (56%) and fluorescent staining was positive in 54 (56%) cases.
Conclusion: Caseous granulomas were detected in females especially. Kinyoun and Fluorescent staining using Auramine O and Rhodamine B are better staining techniques in the detection of AFB than Ziehl Neelsen Staining.


Haematoxylin and eosin; acid fast bacilli; Kinyoun; Ziehl Neelsen; Lymph node.

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