Nasser Sadia Siddiqa, Patil Rashmi K, Kittur Shreekanth K
Department of Pathology, Belagavi Institute of Medical Sciences, Belagavi, India.
Acta Cytol. 2017;61(1):39-46. doi: 10.1159/000452651. Epub 2016 Dec 2.
To study the cytomorphological spectrum of lymph node lesions in HIV-positive patients and correlate the cytological findings with the CD4 count.
This was a cross-sectional study of 23 months' duration which included 110 HIV-positive cases proved according to the guidelines of the National AIDS Control Organisation. Fine-needle aspiration cytology (FNAC) was done on clinically palpable lymph nodes. Special stains and culture were done wherever necessary. CD4 count was done by flow cytometry and subsequently correlated with the cytological findings.
Our study included 110 cases, ranging in age from 6 to 70 years, peaking in the 3rd to 4th decade (n = 46). The male-to-female ratio was 1.75:1 and the predominant site was the cervical group of lymph nodes (n = 71). Each lesion was correlated with CD4 count, laboratory and clinical findings, and was further segregated based on WHO and CDC staging. Cytological lesions were tubercular (53.6%), reactive (27.1%), suppurative (6.4%) lymphadenitis, lymphoma (4.5%), cystic lymphoid hyperplasia (2.8%), metastases (1.9%), cryptococcal lymphadenitis (0.9%). The mean CD4 count was 217.4, 434.4, 181.4, 149, 580, 225, and 207 cells/µL, respectively. There was a highly significant correlation of cytological findings with CD4 count (χ2 value = 44.57 and p < 0.001).
FNAC is a primary, safe, and valuable tool for the identification of opportunistic infections, neoplastic and nonneoplastic lesions, as well as therapeutic modality in certain conditions. Correlation of lesions with CD4 count provides information about immune status, HIV stage and segregating cases, and also aids further evaluation and management.
研究HIV阳性患者淋巴结病变的细胞形态学谱，并将细胞学结果与CD4细胞计数相关联。
这是一项为期23个月的横断面研究，纳入了110例根据国家艾滋病控制组织指南确诊的HIV阳性病例。对临床可触及的淋巴结进行细针穿刺细胞学检查（FNAC）。必要时进行特殊染色和培养。通过流式细胞术检测CD4细胞计数，并随后将其与细胞学结果相关联。
我们的研究包括110例患者，年龄在6至70岁之间，高峰年龄在第三至第四个十年（n = 46）。男女比例为1.75:1，主要部位是颈部淋巴结组（n = 71）。将每个病变与CD4细胞计数、实验室和临床结果相关联，并根据世界卫生组织（WHO）和美国疾病控制与预防中心（CDC）的分期进一步分类。细胞学病变包括结核性（53.6%）、反应性（27.1%）、化脓性（6.4%）淋巴结炎、淋巴瘤（4.5%）、囊性淋巴样增生（2.8%）、转移瘤（1.9%）、隐球菌性淋巴结炎（0.9%）。平均CD4细胞计数分别为217.4、434.4、181.4、149、580、225和207个细胞/微升。细胞学结果与CD4细胞计数存在高度显著相关性（χ2值 = 44.57，p < 0.001）。
FNAC是识别机会性感染、肿瘤性和非肿瘤性病变以及在某些情况下作为治疗方式的主要、安全且有价值的工具。病变与CD细胞计数的相关性提供了有关免疫状态、HIV分期和病例分类的信息，也有助于进一步评估和管理。
