Introduction: Tuberculosis (TB) in children is a neglected aspect of the TB epidemic despite it constituting 20% or more of all TB cases in many countries with high TB incidence. Childhood TB is a direct consequence of adult TB but remains overshadowed by adult TB because it is usually smear-negative. Infants and young children are more likely to develop life-threatening forms of TB than older children and adults due to their immature immune systems. Therefore, prompt diagnoses are extremely important although difficult since clinical and radiological signs of TB can be non-specific and variable in children. In developing countries like India, tuberculous lymphadenitis is one of the most common causes of lymphadenopathy. However, anti-tubercular treatment cannot be given only on clinical suspicion. Cytomorphology with acid fast staining proves to be a valuable tool in diagnosing these cases. Aims: To study the utility of fine needle aspiration cytology (FNAC) and various cytomorphological presentations inreference to Ziehl-Neelsen staining in tuberculous lymphadenitis in paediatric age group. Methodology: Total 120patients attending OPD at Dr. Shankarrrao Chavan Government medical college, Nanded were studied for the period of two years. Result: Out of 120 aspirations from tuberculous lymph nodes, we found that only Necrosis without epithelioid cell granulomas was the most common cytological picture seen in 66 cases followed by necrotising granuloma in 25 cases. ZN-stained smears were positive in 76 cases while culture was positive in only 54 cases. The highest smear and culture positivity was noted in cases with only necrosis.overall AFB positivity was 66.3%. Conclusion: Fine needle aspiration cytology is a safe, cheap procedure requiring minimal instrumentation and is highlysensitive to diagnose tuberculous lymphadenitis. The sensitivity can be further increased by complementing cytomorphology with ZiehlNeelsen (ZN) staining for acid-fast Bacilli (AFB) and microbiological culture.

Keywords: Fine Needle Aspiration Cytology(FNAC); Tuberculous Lymphadenitis; Ziehl-Neelsen (ZN) Staining.