Abstract :
Introduction: The most common lesions encountered in HIV positive patients is Lymphadenopathy. The
cytopathology of these masses encompass a variety of changes that provide insight into the underlying
condition associated with HIV. The present study analyzed the cytological patterns of lymph node lesions
in HIV/AIDS patients by FNAC (Fine Needle Aspiration Cytology) and correlate its findings with serum
CD4 counts.
Materials and Methods: A total 75 cases of all genders and age, already diagnosed as seropositive by
ELISA and presented with lymphadenopathy of > 1 cm were studied in pathology department by FNAC
during the period of 1 and half year. Smears were fixed in ethanol (95%) for PAP (Papanicolaou Stain)
staining. Air dried smears were kept for MGG (May Grunwald Giemsa) and AFB (acid fast bacilli). The
serum CD4 count was assessed by BD FACS Count System.
Results: Male predominance observed with male to female ratio of 1.3: 1. Maximum cases (80%) had
involvement of cervical lymph nodes followed by axillary 6 (8%). The commonest cytological diagnosis
was chronic granulomatous lymphadenitis 30 cases (40%), followed by tuberculous lymphadenitis 27
(36%). The Most common cytomorphological pattern in tuberculous lymphadenitis cases was caseous
necrosis along with epithelioid cells (55.5%). Most of the chronic granulomatous cases (20) had a serum
CD4 count between 200-499 cells/ mL with an average of 330.2 cells/ mL. The minimum average value of
serum CD4 count was observed in tuberculous lymphadenitis was 118.29 cells/ mL.
Conclusion: For HIV lymphadenopathy patients, FNAC is the simple and effective diagnostic modality
which helps in identification of majority of the granulomatous, reactive and opportunistic infections. It
therefore, helps in guiding subsequent management of these patients.
Keyword :
Lymphadenopathy, Cytopathology, FNAC, Smear, Seropositive, Lymphadenitis, Necrosis, Granulomatous 1.