title: Cytopathological and Microbiological Profile of Tuberculous Lymphadenitis in HIV-Infected Patients with Special Emphasis on Its Corroboration with CD4+ T-Cell Counts.
abstract: OBJECTIVE
  The present study was performed to evaluate various cytological patterns and acid fast bacillus (AFB) grades in HIV-infected patients with tuberculous lymphadenitis and to correlate these with each other as well as with peripheral CD4+ T-cell counts.
  
  
  METHODS
  Ninety-two HIV-seropositive patients, cytologically diagnosed with tuberculous lymphadenitis, were evaluated. Fine needle aspiration cytology was performed as an outpatient procedure. Sonographic guidance was sought for internally sited lymph nodes. Cytopathological details were assessed on routinely stained and Ziehl-Neelsen-stained smears. Appropriate AFB grades were assigned. CD4+ T-cell counts were obtained immediately. Finally, the cytopathological findings, AFB grades and CD4+ T-cell counts were corroborated with each other.
  
  
  RESULTS
  Epithelioid cell granuloma in the presence of caseation appeared to be the most frequent (66.3%) cytomorphology on aspirated smears. AFB grades 3+ (37%) and 4+ (35.9%) were the commonest patterns of bacillary involvement. The mycobacterial density and cytological features significantly correlated with CD4+ T-cell counts.
  
  
  CONCLUSIONS
  In HIV-associated tuberculous lymphadenitis, AFB grade and CD4+ T-cell counts worsen with the appearance of necrosis. Here, the peripheral CD4+ T-cell counts inversely correlated with bacillary load. Collectively, peripheral CD4+ T-cell counts, cytological findings and AFB grade exemplify the immune status in these patients.
authors.affiliation: Department of Pathology, North Bengal Medical College and Hospital, Darjeeling, India.
authors.forename: Krishnendu
authors.initials: K
authors.lastname: Mondal
authors.forename: Rupali
authors.initials: R
authors.lastname: Mandal
mesh_terms: D015492:AIDS Serodiagnosis; D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D000293:Adolescent; D000328:Adult; D058491:Bacterial Load; D001431:Bacteriological Techniques; D044963:Biopsy, Fine-Needle / Q000379:methods; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000382:microbiology; D002648:Child; D060085:Coinfection; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000276:immunology; D006679:HIV Seropositivity; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009336:Necrosis; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D013194:Staining and Labeling; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D018084:Ultrasonography, Interventional; D055815:Young Adult