Introduction: Tuberculosis (TB) is a major health problem in developing countries. The most common presentation of extrapulmonary TB is peripheral lymphadenopathy. Fine needle aspiration cytology (FNAC) is a most useful procedure in the evaluation of peripheral lymphadenopathy as a possible noninvasive alternative to excisional biopsy. Aims and Objectives: To compare the result of conventional ZN method with fluorescent method of detection of acid-fast bacilli in lymph node aspirate and to study the efficacy and advantages of using fluorescent stain for detection of acid-fast bacilli in lymph node cytology. Material and Methods: FNAC was performed in 227 cases of lymphadenopathypresented to the department of Pathology, SMIMER, Surat. Routine cytology, conventional ZN method and fluorescent method were performed on aspirated smears. The advantages of the fluorescent method over the conventional ZN method was analyzed. Results: Out of 227 aspirates, 16 were excluded from the study due to diagnosis of malignancy and 211 cases were evaluated. Among the 211 aspirates, 56.87% (120/211) were positive for AFB on the conventional ZN method, while the smear positivity increased to 65.40% (138/211) on the fluorescent method. Conclusions: Fluorescent microscopy is speedy and easy method of screening, and it reduces observer fatigue. The fluorescent method has more advantages than conventional ZN method. The fluorescent method has higher bacillary positivity rates as compare to conventional ZN method. Hence, the fluorescent method can be used with routine cytology for the identification of AFB. 

Keywords: Cytology; Fluorescent Method; Tuberculosis; Ziehl– Neelsen Stain.