Evaluation of Cytological Spectrum of Lymph Node Lesions and Correlation with CD4+ T Cell Count in HIV Positive Patients.
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 11289-11300
AbstractObjective: To evaluate the cytomorphological spectrum of HIV-related Lymphadenopathy and to correlate the FNAC findings with CD4+ T cell count.
Material and methods: The cross-sectional study was conducted on 69 HIV positive patients presenting with superficial lymphadenopathy and lymph nodes were sampled in each case for fine needle aspiration cytology (FNAC). All the smears were stained with May-Grunwald-Giemsa (MGG) & Papanicolaou (Pap) stain and then evaluated under light microscopy; and a cytological diagnosis was rendered. Ziehl-Neelsen (ZN) staining and Mycobacterial culture was also done in 59 and 42 cases respectively. CD4+ T cell (CD4+) count was also evaluated in 59 cases.
Result: The aspirates were adequate in 63(91.3%) patients. Caseating granulomatous lymphadenitis was the most common cytological diagnosis found in 28 cases (40.58%), followed by reactive lymphoid hyperplasia in 16 cases (23.19%). Mean CD4+ count of caseating granulomatous lymphadenitis was 162.9 cells/µL and mean CD4+ count of non Hodgkin lymphoma NHL cases was 239 cells/µL. There was one case of histoplasmosis in our study where CD4+ count was found to be 86 cells/µL. A significant association was found between these FNAC findings and their respective CD4+ count distribution upon Fisher's Exact Test (P value = 0.044).
Conclusion: FNAC is an important diagnostic modality for assessing the cause of lymphadenopathy in HIV. A low CD4+ count is indicative of immunosuppression in HIV patients and may predict the occurrence of opportunistic infections. TB can be suspected when CD4+ count is around 200 cells/µl.
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