Tuberculosis is the leading cause of lymphadenopathy in HIV-infected persons in India: results of a fine-needle aspiration analysis.
HIV infection is associated with a number of opportunistic infections and malignancies frequently involving the lymph nodes. Lymphadenopathy may occur at any stage of HIV infection. We aimed to determine the utility of fine-needle aspiration cytology in evaluating the causes of lymphadenopathy in HIV-infected individuals. Three hundred HIV-infected individuals with lymphadenopathy were included in the study. Fine-needle aspiration (FNA) was performed on peripheral or deep-seated lymph nodes. The material was used for cytological examination using May-Grunwald-Giemsa and haematoxylin and eosin staining. Special stains such as modified Ziehl-Neelsen staining for acid-fast bacilli and periodic acid-Schiff staining for fungi were also performed. The mean age of the study group was 35.0 ± 8.0 y (range 13-74 y). The median CD4 count was 152 cells/μl. Out of the 300 FNA reports, acid-fast bacteria were reported in 130 and cytological findings indicating mycobacterial infection in a further 43 patients. Cryptococcosis was reported in 4 individuals, histoplasmosis in 2 and aspergillosis in 1. Reactive hyperplasia was seen in 89 individuals. Lymphoma was noted in 7 individuals and suppurative inflammation in 5. In conclusion, tuberculosis is the predominant cause of lymphadenitis in HIV-infected individuals in India, especially in those with low CD4 cell counts.
Kamana
Naveen Krishna
NK
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Wanchu
Ajay
A
Sachdeva
Ravinder Kaur
RK
Kalra
Naveen
N
Rajawanshi
Arvind
A
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D003453:Cryptococcosis / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006651:Histocytochemistry; D006660:Histoplasmosis / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D008206:Lymphatic Diseases / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult