Comparison of fine needle aspiration with biopsy in the diagnosis of cutaneous leishmaniasis
DOI:
https://doi.org/10.66344/jpad.v17i3.718Keywords:
Cutaneous leishmaniasis, fine needle aspiration, histopathologyAbstract
BackgroundLeishmaniasis is a zoonotic infection caused by the protozoa belonging to the genus Leishmania. Demonstration of Leishman-Donovan (LD) bodies on histopathological examination of biopsy specimen is considered to be the definitive diagnostic modality. This study was designed to assess the diagnostic value of fine needle aspiration and to compare it with full thickness biopsy.
Patients and methods This was randomized, open label comparison study conducted in department of dermatology, Pakistan Institute of Medical Sciences, Islamabad from 1st June 2007 to 31st July 2007. 15 patients, 15 years of age or older were enrolled in the study. Selection of patients was made on the basis of clinical features. Patients with the lesions having typical clinical features of cutaneous leishmaniasis-like erythematous crusted plaques or nodules were enrolled. Demographic characteristics including age, sex, residential address, site, size, shape and duration of lesions was noted. Informed consent was taken. Procedure and its pros and cons were explained to the patient. Procedure was performed in the FNA room of pathology department under strict aseptic conditions. Local anaesthesia was not given as patients tolerated the pain well. Biopsy specimen was taken from the same lesion under local anaesthesia after doing FNA. Slides were processed and examined. The diagnosis was confirmed on the basis of finding giant cells or Leishman-Donovan bodies on FNA of the lesion.
Results Out of 15 patients 12 patients had positive FNA and three patients had negative FNA report. While the biopsy specimen showed typical histopathological features of cutaneous leishmaniasis in 14 out of 15 patients and one turned out to be a case of ruptured inclusion cyst. So out of 3 negative cases of FNA, one had ruptured inclusion cyst. The diagnostic rate was 80% for FNA and 93.3% for biopsy.
Conclusion Fine needle aspiration seems a reasonably good diagnostic modality for cutaneous leishmaniasis. Its sensitivity is comparable to that of full thickness biopsy.
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Copyright (c) 2016 Ikramullah Khan, Rifat Yasmin
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