title: Cytomorphological Analysis of Lymph Node Lesions in HIV-Positive Patients with CD4 Count Correlation: A Cross-Sectional Study.
abstract: OBJECTIVE
  To study the cytomorphological spectrum of lymph node lesions in HIV-positive patients and correlate the cytological findings with the CD4 count.
  
  
  METHODS
  This was a cross-sectional study of 23 months' duration which included 110 HIV-positive cases proved according to the guidelines of the National AIDS Control Organisation. Fine-needle aspiration cytology (FNAC) was done on clinically palpable lymph nodes. Special stains and culture were done wherever necessary. CD4 count was done by flow cytometry and subsequently correlated with the cytological findings.
  
  
  RESULTS
  Our study included 110 cases, ranging in age from 6 to 70 years, peaking in the 3rd to 4th decade (n = 46). The male-to-female ratio was 1.75:1 and the predominant site was the cervical group of lymph nodes (n = 71). Each lesion was correlated with CD4 count, laboratory and clinical findings, and was further segregated based on WHO and CDC staging. Cytological lesions were tubercular (53.6%), reactive (27.1%), suppurative (6.4%) lymphadenitis, lymphoma (4.5%), cystic lymphoid hyperplasia (2.8%), metastases (1.9%), cryptococcal lymphadenitis (0.9%). The mean CD4 count was 217.4, 434.4, 181.4, 149, 580, 225, and 207 cells/µL, respectively. There was a highly significant correlation of cytological findings with CD4 count (χ2 value = 44.57 and p < 0.001).
  
  
  CONCLUSIONS
  FNAC is a primary, safe, and valuable tool for the identification of opportunistic infections, neoplastic and nonneoplastic lesions, as well as therapeutic modality in certain conditions. Correlation of lesions with CD4 count provides information about immune status, HIV stage and segregating cases, and also aids further evaluation and management.
authors.affiliation: Department of Pathology, Belagavi Institute of Medical Sciences, Belagavi, India.
authors.forename: Sadia Siddiqa
authors.initials: SS
authors.lastname: Nasser
authors.forename: Rashmi K
authors.initials: RK
authors.lastname: Patil
authors.forename: Shreekanth K
authors.initials: SK
authors.lastname: Kittur
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000473:pathology*; D002648:Child; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000601:surgery; D006801:Humans; D008198:Lymph Nodes / Q000276:immunology / Q000473:pathology / Q000601:surgery; D008199:Lymphadenitis / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000601:surgery; D008223:Lymphoma / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000601:surgery