Background: Evaluation of lymphadenopathy is of clinical significance as the underlying disease may range from a treatable infectious etiology to malignant neoplasm.Peripheral lymphadenopathy is common in all age groups and management of cases depends on lymph node pathology, which can be evaluated by fine-needle aspiration or excision biopsy. Objectives: The study was undertaken to assess Cytomorphological spectrum of lymph node lesions on FNA with special reference to Acid Fast Bacilli positivity in TuberculousLymphadenitis. Materials and Methods: A 3 years retrospective analysis of the data was carried out on 944 patients of lymphadenopathy in the Department of Pathology, Mandya Institute of Medical Sciences, Mandya from January 2013 to December 2015. Fine needle aspiration cytology (FNAC) was done and smears were stained with Hematoxylin and Eosin, MayGrunwald-Giemsa and Papanicolaou (PAP) stains. Other stains like Ziehl-Neelson (ZN), Periodic Acid Schiff (PAS), etc were done wherever required. Results: The spectrum of various lymph node lesions on cytomorphological findings in this study showed 560 cases (59.32%) of reactive nature, 178 cases (18.85%) were tubercular , 34 cases (3.6%) were of acute lymphadenitis and 8 cases (1%) were of chronic lymphadenitis. AFB positivity was found in 39.8% of tuberculous lymphadenitis patients. The remaining 164 cases (17.37%) were of malignant lymphadenopathy, consisting 15 cases (1.58%) of primary malignancies i.e. lymphomas and 149 cases (15.78%) of metastasis to lymph nodes. On correlation of FNAC findings with histopathology overall sensitivity, specificity and diagnostic accuracy as 97.9%, 99.7% and 99.3% respectively. Conclusion: Fine needle aspiration study is an important tool for evaluation and management of various lymphoid disorders. It is a safe, simple, cost effective and reliable technique for establishing the diagnosis. Demonstration of AFB helps to establish the diagnosis of tuberculous lymphadenitis.

Keywords: FNAC; Tuberculosis; AFB; Ziehl Neelson Stain.