INTRODUCTION TB still represent a threat challenge to humanity .India has the highest burden of TB in the world account for nearly 1/5 of global burden of disease.In india extrapulmonary TB comprises 20% of all TB cases.Lymph node involment is the most common extrapulmonary manifestation. METHOD AND MATERIAL The Study was conducated at JLNMC Bhagalpur .Sample size was 100 and duration of study was 4 month from1-9-2018 to 31- 12-2018. Hundred cases were detected as granulomatous inammation in giemsa staining of aspirates from FNAC. Granulomatous lesions were grouped into 3 categories . A working diagnosis was arrived at by analysis of history, clinical examination and FNAC and AFB stainig. RESULT Granulomatos lesion- 100 AFB positive cases- 70(44 cases M.TB positive and 26 cases M.TB negative). AFB negative cases- 30 Cytological smear of tuberculous lymphadenitis were grouped into 3 categories. Epitheloid granuloma with necrosis- 60% Only necrosis no granuloma- 30% Epitheloid granuloma without necrosis- 10% Zn stained smear were used for screening and grading of af bacteria. 1+ - smear with occasional bacilli 2+- smear with single scattered AFB 3+- smear with large no of bacilli arranged in bundle. Gender wise distribution granulomatous lesion Female- 60% , Male- 40% Agewise distribution of granulomatous lesion 1-10yrs- 3% 11-20yrs- 11% 21-30yrs- 44% 31-40yrs- 31% 41-50yrs- 8% 51-60yrs- 2% 61-70yrs-0 71-80yrs- 1% Distribution of lesion according to site of fnac Cervical lymph node- 60% Supraclavicular lymph node-20% Axillary lymph node -10% Inguinal lymph node- 5% Preauricular lymph node-3% Skin and subcutaneous lesion-2% DISCUSSION Fnac is a simple and economic procedure for diagnosis of TB compared with core needle biopsy /excision biopsy and also during the follow up of patients with antiTB T/tment .Accurate and timely diagnosis together with effective TB T/t ment is the mainstay of tb care.A conrm diagnosis of TB can only be given an isolation of MTB and DNA sequence of bacteria in aspiraton .Fnac is a very useful and reliable test in case of extrapulmonary TB. Granulomatous inammation is common presentation of tb .Second most most common infectious cause of granulomatous inammation is fungus.Similar study was done by departmet of pathology .In the present study we tried to correlate b/w granulomatous lesion and acid fast positive tubercuous cases.Blind fnac can approach safely in the supercial lesion.In our studys most of the cases from lymph node .Cervical lymph node was the most common site followed by supraclavicular lymph node.Similar study was performed by Majeed muhamma mudassar et al. In our studies male gender more affected then female.Similar study was done by Bezabih et al. In my study granulomatus lesion are divided into 3 category . Epitheloid granuloma without necrosis STUDY OF CORRELATION BETWEEN GRANULOMTOUS LESION ON FNAC AND AFB POSITIVE TB CASES Original Research Paper Dr Rina Kumari Tutor/ Senior Resident Department of Pathology, J L N medical college Bhagalpur Pathology Tuberculosis is the commonest infectious disease in the developing world. Many diagnostic tests are devised for its detection including direct smear examination. This study was designed to corelation b/w AFB positive and patients diagnosed to have granulomatous inammation on Fine Needle Aspiration Cytology using special stains. Materials and Methods: A descriptive cross-sectional survey was done on 100 cases of granulomatous inammation consistent with tuberculosis diagnosed on ne needle aspiration cytology at the Department of Pathology, JLNMC, Bhagalpur.After reporting granulomatous inammation on giemsa staining of aspirates from FNAC, unstained slides were subjected to special stains, like ZN. Cases positive for AFB on ZN stain were noted down along with their frequency and percentages. Results: Forty-four cases (62.85%) of AFB positive smears were reported as TB while 26(37.14%) cases were AFB positive were m.tuberculosis negative . Cervical lymph nodes were the most commonly involved site (60%) and males(60%) were affected more (40%) than females. Most cases of AFB-positive smears were associated with epitheloid granuloma wth caseation necrosis (60%)followed by only caseous necrosis(30%)andepitheloid granuloma(10%). Conclusion: Special stains should be done on all granulomatous inammation cases seen on FNAC for conrmation of TB . ABSTRACT KEYWORDS : FNAC, Granulomtous,AFB Positive TB VOLUME-9, ISSUE-1, JANUARY-2020 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra Dr Dhanesh kumar* Tutor Department of Pathology J L N medical college Bhagalpur *Corresponding Author Dr R .K. Mishra Professor Department of Pathology J L N medical college Bhagalpur 16 X GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS Epitheloid granuloma with necrosis Necrosis without epitheoid granuloma Similar study was done by Afrose Ruquiy et al, Bharti Arati et al.On the basis of appearance, blood mixed aspirate were noted more commonly in 80% cases followed by purulent or pus material in 10% cases and caseous or cheesy material in 10% of cases whereas ,HemIataha et al observed blood mixed aspirates in 87.3% andpurulent or cheesy material 12.7% cases.Our studied most common age group affected 21-40 yrs(75%) followed by 11-20yrs >41-50yrs >1-10 yrs >51-60 yrs(2%). CONCLUSION Fnac is a a sensitive ,simple, soft minimally invasive procedure to diagnosed tuberculous lymphadenitis .Study of both fnac and Zn staining for afb improve the diagnostic yield .If Fnac is supplemented with special stain like ZN staining GMS and PAS. 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