{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T19:33:22Z","timestamp":1783020802287,"version":"3.54.6"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>India has the world's highest burden of tuberculosis (TB). Tubercular lymphadenitis accounts for approximately 40% of extrapulmonary cases. The incidence, demographic profile, and cytologic spectrum vary in different regions. We analyzed the cytologic spectrum and diagnostic yield of Fine Needle Aspiration Cytology (FNAC), Ziehl\u2010Neelsen (ZN) staining, and Cartridge\u2010Based Nucleic Acid Amplification Test (CBNAAT) in a tertiary medical college of North India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A 6\u2010year retrospective study (2018\u20132023) was performed, where 201\u2009TB cases out of 854 lymph node FNACs were analyzed. Cases were categorized into four patterns: Pattern A (Necrosis with granuloma), Pattern B (Granuloma only), Pattern C (Necrosis only), and Pattern D (Acute suppuration). Findings were correlated with ZN grading and CBNAAT results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The incidence of tubercular lymphadenitis was 23.5%. 21\u201330\u2009years was the most common age group involved (37.8%), with a female predilection (69.6%). Cervical nodes were the primary site of involvement (72.1%). Pattern A was the most common (75%). Overall, ZN positivity was 45.3% and CBNAAT was 62.2%. CBNAAT sensitivity was highest in Pattern D (100%) and Pattern B (85%). ZN staining showed the highest sensitivity in Pattern B (60%), though with low bacterial loads (1+). While 38.8% of cases were positive for both ZN and CBNAAT, 23% were detected by CBNAAT alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>FNAC is an effective first\u2010line tool, but morphological patterns may vary. ZN and CBNAAT are complementary; CBNAAT significantly increases sensitivity, particularly in suppurative or paucibacillary cases. A multimodal approach ensures higher diagnostic accuracy and facilitates early initiation of Antitubercular Treatment (ATT).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dc.70137","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T04:46:03Z","timestamp":1777956363000},"page":"568-575","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cytomorphologic Patterns of Tubercular Lymphadenitis and Its Correlation With\n                    <scp>ZN<\/scp>\n                    Stain and\n                    <scp>CBNAAT<\/scp>\n                    : A Six\u2010Year Study in a Tertiary Medical College of North India"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3359-9545","authenticated-orcid":false,"given":"Sudha","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Pathology Dr. Yashwant Singh Parmar Government Medical College  Nahan Himachal Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5981-4701","authenticated-orcid":false,"given":"Anish","family":"Chandran","sequence":"additional","affiliation":[{"name":"Department of Pathology Dr. Yashwant Singh Parmar Government Medical College  Nahan Himachal Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4985-9996","authenticated-orcid":false,"given":"Vinay Kumar","family":"Kaushik","sequence":"additional","affiliation":[{"name":"Department of Medicine Dr. Yashwant Singh Parmar Government Medical College  Nahan Himachal Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1934-0235","authenticated-orcid":false,"given":"Rajni","family":"Kaushik","sequence":"additional","affiliation":[{"name":"Department of Pathology Dr. Yashwant Singh Parmar Government Medical College  Nahan Himachal Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"World Health Organization Global TB Control Report. 227","year":"2008"},{"key":"e_1_2_12_3_1","first-page":"50","article-title":"Difficulties in Managing Lymphnode Tuberculosis","volume":"21","author":"Gupta P. R.","year":"2004","journal-title":"Lung India"},{"key":"e_1_2_12_4_1","first-page":"316","article-title":"Extrapulmonary Tuberculosis","volume":"120","author":"Sharma S. K.","year":"2004","journal-title":"Indian Journal of Medical Research"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.18231\/2394-6792.2019.0015"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/JOC.JOC_207_15"},{"key":"e_1_2_12_7_1","first-page":"26","volume-title":"Public Health Microbiology: A Guide for the Level III Laboratory","author":"Kent P. T.","year":"1985"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.54394\/CJQU6666"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/2141-9248.133466"},{"issue":"7","key":"e_1_2_12_10_1","first-page":"17","article-title":"Rapid Diagnosis of Tubercular Lymphadenopathy by Cartridge\u2010Based Nucleic Acid Amplification Test (CBNAAT) and Its Correlation With Ziehl\u2010Neelsen Staining on Fine Needle Aspiration Cytology","volume":"10","author":"Kumari M.","year":"2020","journal-title":"International Journal of Health Sciences and Research"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.5958\/2394-6792.2015.00010.1"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.25486"},{"issue":"2","key":"e_1_2_12_13_1","first-page":"63","article-title":"Cytomorphological Features of Tuberculous Lymphadenitis on FNAC","volume":"18","author":"Khajuria R.","year":"2016","journal-title":"JK Science"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s42047-022-00111-z"},{"key":"e_1_2_12_15_1","first-page":"201","article-title":"Tuberculous Cervical Lymphadenitis in HIV Positive and Negative Patients","volume":"48","author":"Rajsekaran S.","year":"2001","journal-title":"Indian Journal of Tuberculosis"},{"key":"e_1_2_12_16_1","first-page":"63","article-title":"Incidence of Tuberculosis From Study of Fine Needle Aspiration Cytology in Lymphadenopathy and Acid Fast Staining","volume":"30","author":"Ahmad S. S.","year":"2005","journal-title":"Indian Journal of Community Medicine"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.2174\/1568010043483944"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0041-3879(91)90010-P"},{"issue":"11","key":"e_1_2_12_19_1","first-page":"625","article-title":"Fine\u2010Needle Aspiration Cytology in the Diagnosis of Tuberculous Lesions","volume":"31","author":"Das D. K.","year":"2000","journal-title":"Laboratoriums Medizin"},{"key":"e_1_2_12_20_1","first-page":"1","article-title":"Tuberculous Lymphadenitis: Correlation of Cellular Components and Necrosis in Lymph Node Aspirate With AFB Positivity and Bacillary Count","volume":"33","author":"Das D. K.","year":"1990","journal-title":"Indian Journal of Pathology and Microbiology"},{"issue":"1","key":"e_1_2_12_21_1","first-page":"75","article-title":"Study of Cytomorphological Patterns of Tuberculous Lymphadenitis on Fine Needle Aspiration Cytology","volume":"9","author":"Soumya B. M.","year":"2020","journal-title":"Indian Journal of Pathology: Research and Practice"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.33545\/pathol.2020.v3.i1g.214"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.4103\/0976-9668.166121"},{"issue":"2","key":"e_1_2_12_24_1","first-page":"147","article-title":"Utility of CBNAAT (GeneXpert MTB\/RIF Assay) in Rapid Diagnosis of Extrapulmonary Tuberculosis in a Hepatobiliary Tertiary Center","volume":"60","author":"Batra N.","year":"2004","journal-title":"Annals of the National Academy of Medical Sciences"},{"issue":"4","key":"e_1_2_12_25_1","first-page":"1259","article-title":"Correlation of Various Cytomorphological Patterns of Granulomatous Lymphadenitis With Ancillary Techniques \u2013 ZN Stain & CBNAAT","volume":"5","author":"Parigi M.","year":"2023","journal-title":"International Journal of Academic Medicine and Pharmacy"}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.70137","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/dc.70137","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.70137","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:09:55Z","timestamp":1783015795000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.70137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,4]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/dc.70137"],"URL":"https:\/\/doi.org\/10.1002\/dc.70137","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"value":"8755-1039","type":"print"},{"value":"1097-0339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,4]]},"assertion":[{"value":"2026-02-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}