Comparison Between Auramine-Rhodamine (AR) And Ziehl-Neelsen (ZN) Staining In Cases of Chronic Granulomatous Lymphadenopathy

Abstract

Study Design: Experimental study. 
Place and Duration of Study: This study was conducted at various hospitals of Quetta. 
Materials and Methods: This study includes 103 cases of chronic granulomatous  lymphadenitis, with 101 cases of  
tuberculosis lymph nodes amongst a total of 200 cases of non-neoplastic lymphadenopathy.Their ages ranged from 2 
to 79 years. Maximum number of cases were in 10-29 years age group. Females (69.31%) were affected more as 
compared to males. The commonest presenting symptom was fever. Cervical lymph nodes (83 cases) were the 
commonest site of involvement whereas 18 cases showed multiple site involvement.  
Fluorescent staining of histopatholigical sections from 103 chronic granulomatous lymphadenitis gave positive 
results in 76 out of 103 (73.78%) cases, however Ziehl-Neelsen staining was positive only in 29 out of 103 (28.15%) 
cases. The yield of mycobacteria on fluorescent staining was higly significant (p<0.001) as compared to Ziehl
Neelsen staining thereby providing the superiority of fluorescent stain. 
Result: In a total of 200 cases of non-neoplastic lymphadenopathy 101 cases showed granulomatous lesions, 
histologically consistant with tuberculosis. Other causes of lymphadnopathy were chronic non-specific 
lymphadenitis (n=87) viral lymphadenitis (n=8), fungal lymphadenitis (n=2) and acute bacterial lymphadenitis 
(n=2). Fluorescent staining of histopathological sections from 103 chronic granulomatous lymphadenitis gave 
positive results in 76 out of 103 (73.78%) cases, however Ziehl-Neelsen staining was positive only in 29 out of 103 
(28.15%) cases. 
In 101 cases, the finding were consistent with the diagnosis of tuberculous lymphadenopathy. In our study, 
significantly greater number of cases, 78 out of 101 (P<0.001) diagnosed  as tuberculous lymphadenitis were in age 
groups 10-29 years. Female (69.31%) were more affected than males (30.69%). The common presenting symptom 
was fever. Cervical lymph nodes were commonest site of biopsy. Haemoglobin estimation in 98 cases revealed 
anaemia in 65 out of 101 (66.32%) patients of tuberculous lymphadenopathy. Erythrocyte sedimentation  rate was 
performed in 63 cases and was raised in 52 (82.53%) cases. In a total of 80 cases in whom X-ray chest was 
performed, 14 (15.5%) cases revealed foci of tuberculosis. 
Conclusion: Thus, in conclusion, this study has highlighted the superiorty of fluorescent stain over ZN stain.