Original Article Clinical and cytological features in diagnosis of peripheral tubercular lymphadenitis – A hospital-based study from central India Vivek Gupta a, * , Arvind Bhake b a Assistant Professor, Department of Pathology, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha 442002, India b Professor and Head, Department of Pathology, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha 442002, India 1. Introduction The incidence of extrapulmonary tuberculosis (EPTB) is on rise over the last few years. Peripherial tuberculous lymphade- nopathy is the most common form of extrapulmonary tuberculosis 1–3 and accounts for 25–60% of all EPTB cases, in regions where mycobacterial infection is highly prevalent and presents commonly in lymphnodes draining the head and neck. i n d i a n j o u r n a l o f t u b e r c u l o s i s x x x ( 2 0 1 7 ) x x x – x x x a r t i c l e i n f o Article history: Received 30 March 2016 Accepted 24 November 2016 Available online xxx Keywords: Clinical features Peripheral tubercular lymphadenitis Cytological features a b s t r a c t Background: Tuberculosis lymphadenitis is difficult to diagnose clinically, and often the laboratory confirmation is not available in resource-poor countries. We describe here the symptoms, clinical characteristics, and results of cytological analysis in peripheral tuber- culous lymphadenitis patients. Methods: One hundred and fifty-six patients with peripheral lymph node for cytological evaluation presenting to Department of Pathology, Acharya Vinoba Bhave Rural Hospital, Wardha, India were included in this study. Results: Sixty-nine cases were tuberculous lymphadenitis, with female to male ratio of 1.3:1. One or more constitutional symptoms were present in 59.4% of patients, with 89.9% of lymph nodes ≥2 Â 2 cm and the most common site of involvement was cervical lymph node (70.3%). The lymph nodes were multiple (85.5%), either discrete or matted. Cytomorphologically, hemorrhagic aspirate was observed in 29 cases, well-formed epithelioid cell granuloma with caseous necrosis was seen in 34 cases, and Zeihl Neelsen staining was positive in 45 cases. Correlation between character of aspirate and cytomorphological pattern was found highly significant. Conclusion: These data suggest that constitutional symptoms and clinical and cytological features help in diagnosing cases of peripheral tubercular lymphadenitis and also open new frontiers to further research that affects the cytological features of these cases. © 2016 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved. * Corresponding author. Tel.: +91 9420245648. E-mail address: dr_vivek_gupta@yahoo.com (V. Gupta). Abbreviations: EPTB, extrapulmonary tuberculosis; TBLN, tuberculous lymphadenitis; FNAC, fine needle aspiration cytology; ZN, Ziehl Neelsen; SPSS, software package for statistical analysis; AFB, acid fast bacilli. IJTB-162; No. of Pages 5 Please cite this article in press as: Gupta V, Bhake A. Clinical and cytological features in diagnosis of peripheral tubercular lymphadenitis – A hospital-based study from central India, Indian J Tuberc. (2017), http://dx.doi.org/10.1016/j.ijtb.2016.11.032 Available online at www.sciencedirect.com ScienceDirect journal homepage: http://www.journals.elsevier.com/ indian-journal-of-tuberculosis/ http://dx.doi.org/10.1016/j.ijtb.2016.11.032 0019-5707/© 2016 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.