Fine Needle Aspiration Cytology of Lymphnode in HIV Positive Patients and its Correlation with CD4 Count

摘要

Background: AIDS is a fatal disease with many opportunistic infections. Causes of lymphadenopathy are opportunistic infections or lymphoid malignancy. FNAC is useful tool for the diagnosis of reactive lymphadenitis, acute suppurative lymphadenitis and opportunistic infections in HIV. There is a correlation between CD4 and FNAC findings. There is low CD4 count in reactive hyperplasia, suppurative lymphadenitis & granulomatous inflammation & very low count in lymphoma and Kaposi’s sarcoma. Aims & Objectives: To find out the pathological changes such as infections, benign and malignant lesions in the lymph nodes of HIV positive patients by FNAC and to establish a correlation between clinico-pathological findings , FNAC & CD4 count. Methodology: The study of 100 patients was carried out in the Department of pathology, SMIMER Medical College, Surat. FNAC of the lymph nodes were performed and smears were stained by Giemsa , H&E , PAP & ZN stains to rule out fungus & AFB. CD4 count of the same patients were performed. Results: Out of 100 patients, maximum cases of 31 to 40 years(32%) with M:F of 2:1. cervical LNs(77%) with findings of Tuberculous lymphadenitis (70%), reactive hyperplasia (12%) & Lymphoma (5%) cases. Lymphoma were associated with severe reduction of CD4 count(66 to 145). Conclusion: Incidence of infectious lesions was higher (76%) with maximum number of patients were of Tuberculous lymphadinitis with CD4 count range of 200 to 499 and cases of lymphoma were associated with CD4 count(66 to 145).