Hello and welcome to HCM,
The first FNAC report of the cervical gland suggests collection of pus (inflammtory cells).
Pus collection can occur due to bacterial infection.
However, this report is negative for acid fast bacilli (AFB).
AFB is the causative of tuberculosis
The second FNAC report shows inflammatory cells and granulomas.
Granulomas are present in cases of tuberculosis.
Presence of giant cells and necrosis
are characteristic of tuberculosis.
However, absence of giant cells and necrosis does not rule out tuberculosis.
and X-ray chest are other tests which further potentiates the diagnosis of tuberculosis.
The treatment of tuberculosis is anti-tubercular treatment (ATT).
ATT consists of multiple drugs and for long duration of time.
So, 100% confirmation of tuberculosis is required to start ATT.
Presence of AFB and/or positive culture for tuberculosis is the confirmatory test for tuberculosis.
If these tests are negative, PCR is needed to confirm the diagnosis.
thanks and take care
Dr Shailja P Wahal