Lymphadenopathy In HIV Positive Patients Research Articles

Analysis of the causes of cervical lymphadenopathy using fine-needle aspiration cytology combining cell block in Chinese patients with and without HIV infection

BackgroundCervical lymphadenopathy refers to a frequently observed clinical presentation in numerous pathological conditions. A wide spectrum of diseases can cause cervical lymphadenopathy, irrespective of the fact that the patients are infected with HIV or not. The present study focuses on validating whether the causes of cervical lymphadenopathy differ significantly in HIV and non-HIV patients by using fine-needle aspiration cytology (FNAC) combining cell block.MethodsA total of 589 patients with cervical lymphadenopathy were recruited in the FNA clinic. The samples were obtained by an auto-vacuumed syringe that benefited the sampling more materials. The cytological smears were prepared by Hematoxylin and Eosin (HE), Periodic Acid Schiff (PAS), Gomori’s methenamine silver (GMS) and acid-fast staining. Cell blocks were made if required, and immunohistochemistry stain was performed on the cell block section.ResultsThe study found 453 (76.9%) patients with HIV and 136 (23.1%) patients without HIV infection. The average age of HIV-infected patients was 34.8 ± 10.2 years, which was significantly lower than that of non-HIV-infected patients (42.9 ± 18.1 years) (p < 0.01). Of all patients infected with HIV, 390 (86.1%) were males. This proportion was significantly higher than that of non-HIV-infected patients [65/136 (47.8%)] (p < 0.01). The major causes of cervical lymphadenopathy in HIV positive patients were mycobacterial infection (38.4%), reactive hyperplasia (28.9%), non-specific inflammation (19.9%), and malignant lesions (4.2%). In contrast, the most common causes in HIV negative patients were reactive hyperplasia (37.5%), malignancy (20.6%), non-specific inflammation (19.1%) and mycobacterial infection (12.5%). Opportunistic infections such as non-tuberculous mycobacteria (4.2%), cryptococcosis (1.5%), Talaromyces marneffei (1.5%) and other fungi (0.4%) were found only in HIV-infected individuals. Non-Hodgkin’s lymphoma (2.4%) was the most common malignant lesion in patients with HIV infection, followed by Kaposi’s sarcoma (0.9%) and metastatic squamous cell carcinomas (0.7%). However, the most common malignancy in non-HIV-infected patients was metastatic carcinomas (14%) including small cell carcinomas, adenocarcinomas, squamous cell carcinomas and hepatocellular carcinoma, which were noticeably greater than the HIV patients (p < 0.01).ConclusionsThere were significantly different causes of cervical lymphadenopathy in HIV infected and non-HIV infected patients. FNAC was a useful diagnostic method for differential diagnosis of cervical lymphadenopathy.

CT Texture Analysis of Cervical Lymph Nodes on Contrast-Enhanced [18F] FDG-PET/CT Images to Differentiate Nodal Metastases from Reactive Lymphadenopathy in HIV-Positive Patients with Head and Neck Squamous Cell Carcinoma.

Differentiating nodal metastases from reactive adenopathy in HIV-infected patients with [18F] FDG-PET/CT can be challenging because lymph nodes in HIV-positive patients often show increased [18F] FDG uptake. The purpose of this study was to assess CT textural analysis characteristics of HIV-positive and HIV-negative lymph nodes on [18F] FDG-PET/CT to differentiate nodal metastases from disease-specific nodal reactivity. Nine HIV-positive patients with head and neck squamous cell carcinoma (7 men, 2 women; 29-62 years of age; median age, 48 years) with 22 lymph nodes (≥1 cm) who underwent contrast-enhanced CT with [18F] FDG-PET followed by pathologic evaluation of cervical lymph nodes were retrospectively reviewed. Twenty-six HIV-negative patients with head and neck squamous cell carcinoma with 61 lymph nodes were evaluated as a control group. Each lymph node was manually segmented, and an in-house-developed Matlab-based texture analysis program extracted 41 texture features from each segmented volume. A mixed linear regression model was used to compare the pathologically proved malignant lymph nodes with benign nodes in the 2 enrolled groups. Thirteen (59%) lymph nodes in the HIV-positive group and 22 (36%) lymph nodes in the HIV-negative control group were confirmed as positive for metastases. There were 7 histogram features (P = .017-0.032), 3 gray-level co-occurrence features (P = .009-.025), and 9 gray-level run-length features (P < .001-.033) that demonstrated a significant difference in HIV-positive patients with either benign or malignant lymph nodes. CT texture analysis may be useful as a noninvasive method of obtaining additional quantitative information to differentiate nodal metastases from disease-specific nodal reactivity in HIV-positive patients with head and neck squamous cell carcinoma.

ДИФФЕРЕНЦИАЛЬНАЯ ДИАГНОСТИКА ЛИМФАДЕНОПАТИИ БРЮШНОЙ ПОЛОСТИ У БОЛЬНЫХ ВИЧ-ИНФЕКЦИЕЙ

The objective of the study : to investigate the specific features of intra-abdominal lymphadenopathy in HIV positive patients, to define the best differential diagnostic criteria. Subjects and methods . Medical records of 113 HIV positive patients with intra-abdominal lymphadenopathy for 2012-2017 were retrospectively analyzed. The patients underwent the comprehensive examination including X-ray and endoscopy, laboratory assays, tests of biopsy specimens collected from lymph nodes, microbiological and molecular genetic tests. Results . Due to this comprehensive examination, which included invasive diagnostics, etiology of intra-abdominal adenopathy was confirmed in all 113 patients: 75 (66.4%) were diagnosed with tuberculosis, 29 (25.7%) – mycobacterial infection, and 9 (8.8%) had a lymphoproliferative disease. The article presents the criteria for differential diagnostics between these diseases.

Cytology of HIV Lymphedenopathy- A study of 100 cases

100 patients of lymphadenopathy with human immunodeficiency virus infection were studied by fine needle aspiration cytology of the affected smears. Smears collected were stained by different staining techniques like Papanicolaou taining, Haematoxylin and eosin (H& E) staining, giemsa staining and AFB as well as PAS staining. The maximum number of cases was reported in the age group of 21 to 30 years. Majority of the patients were males. The maximum number of cases had reactive lymphadenitis (52%), followed by tuberculosis (45%) non-Hodgkin’s lymphoma (2%) and dermatopathic lymphadenitis (1%). FNAC is an important diagnostic tool in the evaluation of lymphadenopathy in HIV-positive patients.

Cytopathology Lymphadenopathy Feature in HIV Positve Patient: Diagnosis Tools Comorbidities

Lymphadenopathy is enlarged lymph nodes caused by infection, inflammation or malignancy. On HIV positive patients, lymphadenopathy is one of the most common clinical manifestations and it is usually persistent. Fine-needle aspiration biopsy (FNAB) is an effective cytology technique in determining the diagnosis of lymphadenopathy. This study aimed to describe the cytopathology of lymphadenopathy in HIV positive patients. This is a descriptive study of 21 cases of lymphadenopathy in patients with HIV positive who underwent FNAB examination in Anatomical Pathology Department of Dr.Hasan Sadikin Hospital between 2013-2014. Medical data was taken from the patient medical records including age, sex, location, size and cytopathological diagnosis. Cytopathology overview of FNAB specimens were reassessed by 2 pathologists. In this study, lymphadenopathy in HIV positive patients were mainly found in men (n = 15.71%) with an average age between 20-30 years. The most frequent location was the neck (n = 20.95.2%). The lymph nodes size were found between 0.5-3 cm. Most diagnosis was tuberculous lymphadenitis (n = 15.71%) with the most common cytology feature was granulomatous lymphadenitis (n = 5.33.3%) and suppurative lymphadenitis (n = 5.33.3%). FNAB examination in lymphadenopathy is very helpful to identify the cause of infection in HIV positive patients. Keywords: FNAB, HIV, lymphadenopathy, cytopathology

Fine-needle aspiration cytology findings in human immunodeficiency virus lymphadenopathy

Thirty-six human immunodeficiency virus (HIV)-positive patients with lymphadenopathy were subjected to fine-needle aspiration cytology (FNAC) over a period of 2 years. The maximum number of cases was reported in the age group of 21 to 30 years. Majority of the patients were males. The maximum number of cases had tuberculosis (58.3%) followed by reactive lymphadenitis (36.1%), non-Hodgkin's lymphoma (2.7%) and acute suppurative lymphadenitis (2.7%). FNAC is an important diagnostic tool in the evaluation of lymphadenopathy in HIV-positive patients.

Fine Needle Aspiration Diagnosis in HIV-Related Lymphadenopathy in Mangalore, India

To evaluate the usefulness of fine needle aspiration (FNA) study of lymph nodes in HIV-positive patients. The study was conducted at Kasturba Medical College, Mangalore, India. Samples from lymph nodes of 48 HIV-positive patients were taken and air dried, and wet smears were made. After staining with routine cytologic stains and special stains, detailed cytomorphologic study was conducted. Tuberculosis accounted for nearly half (48%) the cases,followed by HIV lymphadenitis (36%), lymphoma (10%), suppurative lymphadenitis (2%), Mycobacterium avium-intracellulare lymphadenitis (2%) and metastases (2%), in descending order of their frequency. A suppurative picture, which was found in 13% of cases of tuberculous lymphadenitis in AIDS patients, occasionally was misleading without the help of acid fast bacilli stain. FNA is a useful tool in the diagnosis of lymphadenopathy in HIV-positive patients provided that proper safety measures are taken to avoid contracting the infection.

Effect of HIV status on chest radiographic and CT findings in patients with tuberculosis

Aim: To compare the chest radiographic and chest CT findings of tuberculosis according to HIV status. Patients and methods: Ninety-eight HIV-tested patients with cultures positive for Mycobacterium tuberculosis (Mtb) between January 1991 and December 1993 whose clinical charts and radiographic records were available for review formed the study population. There were 67 HIV-positive patients (51 men, 16 women) and 31 HIV-negative patients (23 men, 8 women). Chest CT scans were available for review in 15 HIV-positive and four HIV-negative patients. Results: On chest radiographs, HIV-positive patients had mediastinal lymphadenopathy (60% vs. 23%) and atypical infiltrates (55% vs. 10%) significantly more frequently than HIV-negative patients. Conversely, HIV-negative patients had infiltrates typical for reactivation tuberculosis (77% vs. 30%) and cavitation (52% vs. 18%) significantly more frequently than HIV-positive patients. The chest CT scans showed a similar trend, but significant differences were only seen regarding more frequent bilateral mediastinal lymphadenopathy in HIV-positive patients and more frequent cavitation in HIV-negative patients. Conclusion: This study demonstrates significant differences in chest radiographic and chest CT appearances of tuberculosis according to HIV status. HIV-positive patients have more frequent atypical infiltrates and mediastinal lymphadenopathy, and less frequent cavitation and infiltrates typical for reactivation tuberculosis than do HIV-negative patients.