Fine Needle Aspiration Cytology of Lymphadenopathy in HIV-Infected Patients

Acquired immunodeficiency syndrome (AIDS) was first recognized in United States in 1981. In 1983, human immunodeficiency virus (HIV) was isolated from a patient with lymphadenopathy, and by 1984 it was demonstrated to be the causative agent of AIDS (1). Lymph nodes, which form the bulk of lymphoid tissue, are the major anatomic site for establishing and propagation of HIV infection. Lymphadenopathy is common in HIVinfected patients. The management of these patients requires evaluation of the cause of lymphadenopathy. Clinical examination and radiological investigations on their own have diagnostic limitations. Incision or excision biopsy for histological evaluation is time consuming and expensive (2).The present study was done to know the cytomorphologic smear patterns in lymphadenopathy in HIV positive patients and to determine the role of FNAC as a first line diagnostic procedure in the management of these patients. Material and Methods FNAC of lymph nodes of 74 HIV positive patients was done over a period of one year. In each case, a brief clinical history, general physical and local examination along with evaluation of the relevant investigations was carried out. The aspiration was done with a 21-23 gauge fine needle. The smears were routinely stained with Papanicolaou (PAP), May-Grünwald Giemsa (MGG) and Modified Ziehl-Neelson (ZN) stains. Special stains like Introduction Abstract To study the Fine needle aspiration cytology of lymphadenopathy in HIV-infected patients.Aspiration of lymph nodes was done with a 21-23 gauge fine needle in 74 HIV positive patients with lymphadenopathy. The smears were routinely stained with Papanicoloau, May Grünwald Giemsa, and Modified ZiehlNeelson stains. Periodic acid Schiff and Grocott's methanamine stain were used wherever necessary. The most common cytological diagnosis was tubercular lymphadenitis (38 cases) followed by reactive hyperplasia (22 cases) and acute lymphadenitis/abscess (8 cases). There was one case each of Non Hodgkin lymphoma and metastatic carcinoma. 4 cases had unsatisfactory aspirates. The cytological diagnoses were concordant with the histological diagnoses in 19 out of 20 cases in which subsequent biopsy was available. FNAC is a very useful tool in the diagnosis of enlarged lymph nodes in HIV-infected patients. It is a quick, inexpensive, outdoor procedure and suitable for developing countries like India. The technique has high diagnostic accuracy.