Abstract
Background: Lymphadenopathy in HIV/AIDS patients is the earliest andcommonest manifestation of opportunistic infection and malignancies. FNAC is a simple technique which is safe and minimal traumatic to patients.
Aims of Study: To Evaluate the Cytomorphological spectrum of lymphadenopathy in HIV seropositive cases using FNAC technique and to co-relate cytomorphological pattern with Clinical features, CD4 count and Hematological alterations.
Method: The study was conducted in the department of pathology S.M.S. medical college Jaipur from Jan 2016 to end of 2017. FNAC performed on 100 cases with lymphadenopathy. Aspirates stained with H&E and giemsa in routine and special stains whenever indicated.
Result: Out of 100 cases, maximum cases were in age group 26-45 years in 71% with male predominance in 64%. Most common site of lymphadenopathy was cervical region in 72%.Tubercular lymphadenitis was the most common cause of lymphadenopathy in 65% with mean CD4 count 227.40 cells/µl, followed by reactive in 20%, mean CD4 count 546.45cells/µl, suppurative in 11%, mean CD4 count 162.72 cells/µl, lymphoma in 2%, mean CD4 count 565.50 cells/µl and 2% metastatic malignancies, mean CD4 count <100cells/µl. Most common pattern of tubercular lymphadenitis was epithelioid cell granuloma with caseous necrosis seen in 58.46% cases. Grade 1+ was the most common on ZN grading of AFB with mean CD4 count was 257.08 cells/µl.
Conclusion: Tuberculosis was the most common cause of lymphadenopathy. FNAC is a rapid easily performed technique in HIV seropositive cases for early and appropriate diagnosis.
Keywords: HIV, Lymphadenopathy, FNAC, CD4 count.
References
- A Shobhna, S K Guha, K Mitra, A Das Gupta, D K Neogi, S C Hazra, people living with HIV infection / AIDS – A study on lymph node FNAC & CD4 Count Indian journal of medicine & microbiology 2002 ; 20 : 99 – 101.
- Kumar V, Abbas AK, Fausto N, Aster JC. Disease of immune system. In: Robbins and Cotran Pathologic basis of disease. Philadelphia: Elsevier;2011 p.235-49.
- Neelima Tirumalasetti & Prem Latha; LN cytology in HIV sero positive cases with hematological alteration, Indian Journal of medical research 2014, 139 (2); 301-307.
- Jayaram G, Chew MT: Fine needle aspiration cytology of Lymph nodes in HIV- infected individuals. ActaCytol. 2000; 44: 960-966.
- H R Vanisri, N M Nanditi, R Sunila. Fine needle Aspiration cytology finding in human immunodeficiency virus lympha-denopathy; Indian journal of Pathology µbiology 2008:51; 481-484.
- Prasad R, Garg SK, Mukerji PK, Agarwal PK. Role of fine needle aspiration cytology in the diagnosis of lymphade-nopathy. Indian J Chest Dis Allied Sci1993; 35 : 27-9.
- Amrutha Gorva, Satyanarayana Veeragandham, V. G. Prasad. “Lymph Node Aspiration Cytology Finding in HIV Infected Cases of a Rural Population in South India.” Journal of Evolution of Medical and Dental Sciences 2015; Vol. 4, Issue 83, October 15; Page: 14576-14581, DOI: 10.14260/jemds/2015/2072.
- https://m.dailyhunt.in>india>english.World AIDS Day 2017
- Jayshree Khiste, SmitaShek, Nand Kumar Deshpandey, GopalPandit, Pushkar Matkari, FNAC study of HIV lymphadenopathy & its correlation c CD count; J Res medical sciences 2015; 3 (10) 2635-2638.
- Ratan K, Bhubon Singh N, Arun Kumar, Shikha NG Neteshor MS cytomorpho-logical diagnosis of lymphadenopathy by fine needle aspiration cytology in HIV Positive patients & its correlation with CD4 count – a hospital based 2yr cross sectional study; IOSR journal of dental & medical sciences (IOSR – JDSS); 2014; 13; 49-54.
- Parikh U.R., et al (2012) Diagnostic Utility of FNAC in HIV Positive Lymphadenopathy. Journal of Clinical Research Letters, ISSN: 0976-7061 & E-ISSN: 0976-707X, Volume 3, Issue 2, pp.-37-40.
- Diagnostic Utility of FNAC in HIV Positive Lymphadenopathy, Journal of Clinical Research Letters,3(2),2012,37-40.
- Rajesh Singh Laishram, et.al. fine needle aspiration cytology of HIV related lymphadenopathy in Manipur. JIACM 2014; 15 (2) 1-5.
- Deshmukh A T, Jagtap W, Nomaan Nafees; cytological evaluation of lympha-denopathy in HIV patients international Journal of recent trends is science and technology; ISSN 2013; vol 6, 125-129.
- Pushpraj Singh Baghel, Et al : A study on use of FNAC for the diagnosis of lymphadenopathy in HIV Positive patients compared to conventional Biopsy & correlation of findings CD4 count; Journal of evolution of Medical & Dental Sciences 2013;2;9261-9268.
- Satyanarayana S, Kalghati AT, Muralidhar A, Prasad RS. Jawed KZ, Trehan A. Fine needle aspiration cytology of lymph nodes in HIV infected patients. MJAF I. 2002;58: L33-37.
- Amit Agravat, Hardik Sanghvi, Gauravi Dhruva; fine needle aspiration cytology study of lymph node in HIV patient & CD4 count :int J Res med 2013; 2 (2); 16-19.
- Shenoy R, Kapadi SN, Pai KP, Kini H, Mallya S, Khadilkar UN, et al, fine needle aspiration diagnosis in HIV related Lymphadenopathy in Mangalore, India, ActaCytol. 2002;45:35-9.
- Reid AJ, Miller RF, Kocjan GL. Diagnostic utility of fine needle aspiration (FNA) Cytology in HIV-infected patients with lymphadenopathy. Cytopathology. 1998; 9: 230-9.
- Kumar S, Ferns S, Sujatha S, Jatiya L. Acid-fast staining patterns and their correlation with HIV positivity (lett). ActaCytol2005; 49 : 111-2.
- Kumarguru BN, Kulkarni MH, Kamaken NS, FNAC of peripheral lymphnode in HIV positive patients. ScikuMed 2009;;4-12.
- E Martin-Bates, A Tanner, S K Suvarna, G Glazer, D V Coleman Use of fine needle aspiration cytology for investigating lymphadenopathy in HIV positive patients, 54Clin Pathol 1993;46:564-566
- Bottles K, McPaul L W, Volberding P. Fine-needle aspiration biopsy of patients with the Acquired Immunodeficiency Syndrome (AIDS): Experience in an outpatient clinic. Ann Intern Med 1988;108:42-5.
- Naveen K, Uday B. Nayak .̋clinico-pathological correlation of lymphaden-opathy in HIV positive patient’s ̋.Journal of evidence based medicine and healthcare; volume 2, Issue 28, july13 ,2015;page:4099-4106, DOI:10.18410/jebmh/2015/583
Corresponding Author
Dr Anita Harsh
241/3 Parwati Marg, Rajapark Jaipur INDIA
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.81
