Abstract
Exfoliative and aspiration cytologies play a major role in the management of patients with human immunodeficiency virus infection. Common cytology samples include cervicovaginal and anal Papanicolaou tests, fine needle aspirations, respiratory specimens, body fluids, Tzanck preparations, and touch preparations from brain specimens. While the cytopathologists need to be aware of specific infections and neoplasms likely to be encountered in this setting, they should be aware of the current shift in the pattern of human immunodeficiency virus-related diseases, as human immunodeficiency virus patients are living longer with highly active antiretroviral therapy and suffering fewer opportunistic infections with better antimicrobial prophylaxis. There is a rise in nonhuman immunodeficiency virus-defining cancers (e.g., anal cancer, Hodgkin's lymphoma) and entities (e.g., gynecomastia) from drug-related side effects. Given that fine needle aspiration is a valuable, noninvasive, and cost-effective tool, it is frequently employed in the evaluation and diagnosis of human immunodeficiency virus-related diseases. Anal Papanicolaou tests are also increasing as a result of enhanced screening of human immunodeficiency virus-positive patients for cancer. This paper covers the broad spectrum of disease entities likely to be encountered with human immunodeficiency virus-related cytopathology.
Highlights
The current human immunodeficiency virus (HIV) pandemic has changed considerably, as infected people are living longer with chronic HIV infection due to highly active antiretroviral therapy (HAART)
The spectrum of malignancies encountered in HIV-positive patients has expanded to include both acquired immune deficiency syndrome (AIDS)-defining cancers, such as cervical cancer, Kaposi sarcoma (KS), and non-Hodgkin’s lymphoma (NHL), as well as non-AIDS-defining cancers (NADC), such as Hodgkin’s lymphoma, anal cancer, lung carcinoma, and nonmelanotic skin cancer [1]
The impact of vaccination may be limited in HIV-positive women due to the high diversity of oncogenic human papillomavirus (HPV) seen in this population [41]
Summary
The current human immunodeficiency virus (HIV) pandemic has changed considerably, as infected people are living longer with chronic HIV infection due to highly active antiretroviral therapy (HAART). EBV infection has been linked to Hodgkin’s lymphoma [8], plasmablastic lymphoma (PBL) [9], and leiomyosarcoma [10]. Both exfoliative and aspiration cytologies play a major role in the management of patients with HIV. The diagnosis of Castleman’s disease may prove challenging by FNA alone In such cases as in lymphadenopathy and bone and soft tissue lesions, a concomitant needle biopsy is recommended if resources permit. Another limitation is that FNA may not exclude all coexisting pathologies (e.g., a lymph node with lymphoma and Kaposi sarcoma).
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