title: Diagnostic accuracy of fine needle aspiration cytology in providing a diagnosis of cervical lymphadenopathy among HIV-infected patients.
abstract: BACKGROUND
  Opportunistic infections and malignancies cause lymphadenopathy in HIV-infected patients. The use and accuracy of fine needle aspiration cytology in diagnosing of cervical lymphadenopathy among HIV-infected patients is not well studied in Uganda.
  
  
  OBJECTIVE
  The aim of this study was to determine the diagnostic accuracy of fine needle aspiration cytology in providing a diagnosis of cervical lymphadenopathy among HIV-infected patients in Uganda.
  
  
  METHODS
  We consecutively recruited adult HIV-infected patients with cervical lymphadenopathy admitted to Mulago Hospital medical wards. Clinical examination, fine needle aspiration and lymph node biopsy were performed. We estimated the sensitivity, specificity; negative and positive predictive values using histology as the gold standard.
  
  
  RESULTS
  We enrolled 108 patients with a mean age of 33 years (range, 18-60), 59% were men and mean CD4 was 83(range, 22-375) cells/mm(3). The major causes of cervical lymphadenopathy were: tuberculosis (69.4%), Kaposi's sarcoma-KS (10.2%) and reactive adenitis (7.4%). Overall fine needle aspiration cytology accurately predicted the histological findings in 65 out of 73 cases (89%) and missed 7 cases (9.5%). With a sensitivity of 93.1%, specificity of 100%, positive predictive value of 100% and negative predictive value of 78.7% for tuberculosis and 80%; 98.4%;88.9% and 98.9% for KS respectively. No fine needle aspiration complications were noted.
  
  
  CONCLUSIONS
  Fine needle aspiration cytology is safe and accurate in the diagnosis of tuberculosis and KS cervical lymphadenopathy among HIV-positive patients.
authors.affiliation: School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda ; Mengo Hospital, Department of Medicine, Kampala, Uganda.
authors.forename: David
authors.initials: D
authors.lastname: Muyanja
authors.affiliation: School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda ; Mulago National Referral Hospital, Kampala, Uganda ; Department of Physiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Robert
authors.initials: R
authors.lastname: Kalyesubula
authors.affiliation: School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda ; Mulago National Referral Hospital, Kampala, Uganda ; Mulago Palliative Care Unit, Kampala, Uganda.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Namukwaya
authors.affiliation: Mulago National Referral Hospital, Kampala, Uganda ; Department of Pathology, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Othieno
authors.affiliation: School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Harriet
authors.initials: H
authors.lastname: Mayanja-Kizza
mesh_terms: D000293:Adolescent; D000328:Adult; D044963:Biopsy, Fine-Needle / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008206:Lymphatic Diseases / Q000175:diagnosis*; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis; D055815:Young Adult
keywords: Fine needle aspiration cytology; HIV; cervical lymphadenopathy
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