Study Of Lymph Node Cytology In HIV Seropositive Patients And Its Correlation With CD4 Count

Kirti Jaiswal; Harshwardhan Bahirat

Volume : IX, Issue : VI, June - 2020

Study Of Lymph Node Cytology In HIV Seropositive Patients And Its Correlation With CD4 Count

Kirti Jaiswal, Harshwardhan Bahirat

Abstract :

HIV/AIDS is a major health problem globally. India bears the third highest HIV patients load worldwide. The aim of this study was to identify the different causes of lymphadenopathy among HIV infected patients in central India and correlate them with CD4 T cell counts. The clinical stage is useful for assessment at baseline or entry into long-term HIV care and in the follow-up of patients in care and treatment program. This study also aims to compare the cytomorphological diagnosis of lymph node with available clinical parameters and categorize the patient according to the WHO clinical staging for HIV and AIDS. In the present study 79 cases were evaluated. Fine Needle Aspiration Cytology (FNAC) was performed as an outpatient procedure in the Department of Pathology. Smears were stained routinely with Hematoxylin & Eosin, Papanicolaou stain, May-Grunwald Giemsa (MGG) and Ziehl Neelson stain (ZN) for acid fast bacilli (AFB). CD4 T cell count at the time of fine needle aspiration was used. Out of total 79 cases, 44 (55.70%) were typed as tubercular lymphadenitis, 14 (17.72%) as reactive lymphadenitis, 09 (11.40%) as suppurative lymphadenitis, 6 (7.59%) as granulomatous lymphadenitis, 3 (3.80%) as Non Hodgkin�s lymphoma and 1 (1.26%) as metastases of squamous cell carcinoma. The WHO clinical staging was done for 77 cases. It included 7 (9.09%) cases in stage I, 7 (9.09%) cases in stage II, 16 (20.78%) cases in stage III and 47 (61.04%) cases in stage IV. CD4 T lymphocyte counts showed a descending pattern with progression of staging. Tubercular lymphadenitis constituted the most common condition in HIV positive lymph node aspirates. A cytological diagnosis of non-specific granulomatous lymphadenitis needs further etiological workup. FNAC findings in HIV lymphadenopathy are noticeably different in India in comparison to the western countries.