Role of fine-needle aspiration cytology in human immunodeficiency virus-associated lymphadenopathy: a cross-sectional study from northern India.

OBJECTIVE

To evaluate the role of fine-needle aspiration cytology in the diagnosis of human immunodeficiency virus (HIV)-associated lymphadenopathy.

DESIGN

Case series.

SETTING

Tertiary care teaching hospital, India.

PATIENTS

Fifty consecutive HIV-positive patients, who presented with lymphadenopathy at the out-patient department and antiretroviral therapy clinic.

RESULTS

Tubercular lymphadenitis was the most common diagnosis, reported in 74% (n=37) of patients; 97.2% of them were acid-fast bacilli-positive. Reactive lymphadenitis and fungal lymphadenitis were present in 10 and 1 cases, respectively. The most common cytomorphological pattern of tubercular lymphadenitis was necrotising suppurative lymphadenitis, present in 43.2% (n=16) of patients. Of eight biopsies done in reactive cases, six turned out to be tubercular lymphadenitis. Fine-needle aspiration cytology had a sensitivity of 83.7% for diagnosing tubercular lymphadenitis.

CONCLUSION

Necrotising suppurative lymphadenitis should be recognised as an established pattern of tubercular lymphadenitis. Reactive patterns should be considered inconclusive rather than a negative result, and re-evaluated with lymph node biopsy. Fine-needle aspiration cytology is an excellent test for diagnosing tubercular lymphadenitis in HIV-associated lymphadenopathy.