Journal de cytologie et d'histologie

Cytological Evaluation of Lymphadenopathy in HIV Seropositive Patients

Abstract

Huzefa Ali Turkey and Jayawant W Mahadani

Background: Lymphadenopathy accounts for one of the most common lesions encountered in HIV positive patients. The cytopathology of these masses encompass a variety of changes that provide insight into the underlying condition associated with HIV. Aim of the present study was to analyze the cytological patterns of lymph node lesions in HIV/AIDS patients by Fine Needle Aspiration Cytology (FNAC) and correlate its findings with serum CD4 counts.
Method: A total 75 cases of all genders and age, already diagnosed as seropositive by ELISA and presented with lymphadenopathy of ≥1 cm were studied in the Department of Pathology by FNAC during the period of 1 and half year. Smears were fixed in 95% ethyl alcohol for PAP staining. Air dried smears were kept for MGG and AFB. The serum CD4 count was assessed by BD FACS Count System.
Results: Male predominance observed with male to female ratio of 1.3: 1. Maximum cases (80%) had involvement of cervical lymph nodes followed by axillary 6 (8%). The commonest cytological diagnosis was chronic granulomatous lymphadenitis 30 cases (40%), followed by tuberculous lymphadenitis 27 (36%). Most common cytomorphological pattern in cases of tuberculous lymphadenitis was caseous necrosis with epithelioid cells (55.5%). Most of the cases (20 cases) of chronic granulomatous had a serum CD4 count between 200-499 cells/μL with a mean of 330.2. The least mean value of serum CD4 count was seen in tuberculous lymphadenitis and it was 118.29 cells/μL.
Conclusion: FNAC is the simple and very effective diagnostic modality for HIV lymphadenopathy patients. It guides identification of majority of the granulomatous, reactive, and opportunistic infections. It therefore, helps in guiding subsequent management of these patients.