TY - JOUR T1 - The diagnostic yield of sampling techniques used in the diagnosis of tuberculous lymphadenitis JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P2780 AU - Laura-Jane Smith AU - Yasser Madani AU - Akeel Jubber AU - Angela Hauser AU - Bridget Hall Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P2780.abstract N2 - Introduction:Lymphadenitis is the commonest manifestation of extrapulmonary tuberculosis (TB). It remains a diagnostic challenge and requires a high degree of clinical suspicion as it mimics other conditions and can yield inconsistent investigation findings.Objective:To evaluate the yield of various sampling techniques used in diagnosing tuberculous lymphadenitis.Methods:Medical records of 97 patients diagnosed with tuberculous lymphadenitis between 2009 and 2011 in a district general hospital in Essex, UK, identified from the TB database, were retrospectively reviewed.Results:26% had intrathoracic and extrathoracic nodes, 60% extrathoracic and 14% intrathoracic only. Most commonly affected nodes were supraclavicular (33%), cervical (32%) and inferior mediastinal (24%). Fine needle aspiration (FNA) was undertaken in 24 cases and was positive for microbiology in 15 (63%, microscopy 7, culture 10) and for cytology in 5 (21%). Trucut biopsy was undertaken in 9 cases and was positive for microbiology in 3 (33%, microscopy 0, culture 3) and for histology in 8 (89%). Excision biopsy was undertaken in 49 cases and was positive for microbiology in 21 (43%, microscopy 2, culture 19) and histology in 43 (88%).Conclusion:Contrary to previously published data, FNA provided the highest yield for both microscopy and culture. The literature has traditionally advocated excisional biopsy as the diagnostic procedure of choice given its high sensitivity. FNA has emerged as a safer, quicker, simpler and less invasive alternative. If FNA is negative and clinical suspicion remains high, trucut or excisional biopsy should be pursued. Definitive diagnosis is by culture which remains the gold standard. ER -