Authors : Bharat U. Patil, Anshu , Nitin M. Gangane
DOI : 10.18231/j.ijpo.2019.066
Volume : 6
Issue : 3
Year : 2019
Page No : 343-347
Objective: To assess the role of fine needle aspiration cytology (FNAC) and to determine the cytomorphological profile in persons infected with human immunodeficiency virus presenting with lymphadenopathy.
Materials and Methods: This was a five year (2010-2015) analysis of 54 HIV positive cases who presented with lymphadenopathy. Archival FNAC smears stained with Papanicolaou, Giemsa and Ziehl-Neelsen stains were reviewed for their cytological features.
Results: Lymph nodes from 54 HIV-positive patients in the age range of 11-61 years were reviewed. The most common FNA diagnosis was tubercular lymphadenitis (n=24). The other diagnoses were: reactive lymphadenitis (n=11), suppurative lymphadenitis (n=6), lymphoma (n=9), metastases (n=3) and cryptococcal lymphadenitis (n=1). Of the 24 cases of tubercular lymphadenitis, seven showed epithelioid granulomas with Langhan’s giant cells and caseous necrosis. Numerous clusters of epithelioid cells in reactive background were noted in one case which was AFB positive. There were five cases which showed mostly caseous necrotic material with few epithelioid cells. Our study found that three cases showed only presence of acellular caseous necrosis. Caseous necrotic material with few lymphocytes and histiocytes and no epithelioid cells were reported in four cases. The remaining four cases showed tubercular abscess showing predominantly neutrophils along with epithelioid cells and semi fluid necrosis. These cases were AFB positive.
Conclusion: FNAC is a cost-effective technique in patients of HIV lymphadenopathy to segregate lymph nodes that need to be biopsied from infective lymphadenopathy.
Keywords: Lymphadenopathy, Fine needle aspiration cytology, Tubercular lymphadenitis, Human immunodeficiency virus, Cytology.