Role of fine-needle aspiration cytology in human immunodeficiency virus-associated lymphadenopathy: a cross-sectional study from northern India
Open accessAbstract
OBJECTIVE: To evaluate the role of fine-needle aspiration cytology in the diagnosis of human immunodeficiency virus (HIV)-associated lymphadenopathy. DESIGN: Case series. SETTING: Tertiary care teaching hospital, India. PATIENTS: Fifty consecutive HIV-positive patients, who presented with lymphadenopathy at the out-patient department and antiretroviral therapy clinic. RESULTS: Tubercular lymphadenitis was the most common diagnosis, reported in 74% (n=37) of patients; 97.2% of them were acid-fast bacilli-positive. Reactive lymphadenitis and fungal lymphadenitis were present in 10 and 1 cases, respectively. The most common cytomorphological pattern of tubercular lymphadenitis was necrotising suppurative lymphadenitis, present in 43.2% (n=16) of patients. Of eight biopsies done in reactive cases, six turned out to be tubercular lymphadenitis. Fine-needle aspiration cytology had a sensitivity of 83.7% for diagnosing tubercular lymphadenitis. CONCLUSION: Necrotising suppurative lymphadenitis should be recognised as an established pattern of tubercular lymphadenitis. Reactive patterns should be considered inconclusive rather than a negative result, and re-evaluated with lymph node biopsy. Fine-needle aspiration cytology is an excellent test for diagnosing tubercular lymphadenitis in HIV-associated lymphadenopathy.
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In a TB endemic setting, features resembling suppurative lymphadenitis are known to be a challenge for pathologists to rule out TB, especially in immunocompromised patients.
“In a TB endemic setting, features resembling suppurative lymphadenitis are known to be a challenge for pathologists to rule out TB, especially in immunocompromised patients.9”
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- Authors
- Department of Medicine, P. A. D. R. H., Kumar, N., Gupta, B., Sharma, B., Kaushal, M., Rewari, B., & Sundriyal, D.
- Affiliations
- Post Graduate Institute of Medical Education and Research (IN)
- Venue
- Hong Kong Medical Journal
- Publisher
- Hong Kong Academy of Medicine Press
- Published
- 2014-11-21
- Volume
- 21
- Issue
- 1
- Pages
- 38-44
- ISSN
- 1024-2708 (ISSN-L)
- OpenAlex
- W2334999468
- Cited by
- 15
- References
- 23
- Citations by year
- 2023: 1 · 2021: 3 · 2020: 5 · 2017: 1 · 2016: 3 · 2015: 2
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Hong Kong Medical Journal (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lymphadenopathy Diagnosis and Analysis
- Health Sciences › Medicine › Surgery › Diagnosis and treatment of tuberculosis
- Health Sciences › Medicine › Oncology › Viral-associated cancers and disorders
- Keywords
- HIV-associated lymphadenopathy, fine needle aspiration cytology, tuberculous lymphadenitis, acid-fast bacilli, reactive lymphadenitis, diagnostic sensitivity, lymph node biopsy, people living with HIV
- MeSH terms
- Adult, AIDS-Related Complex, Cross-Sectional Studies, Female, HIV, Humans, India, Lymph Nodes, Lymphadenitis, Male, Outpatients, Biopsy, Fine-Needle
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