Granulomatous Inflammation in Human Immunodeficiency Virus Positive Patients with Hodgkin's Lymphoma: A Potential Confounder of Fine Needle Aspiration Diagnosis

2017 ◽  
Vol 6 (5) ◽  
pp. S47-S48
Author(s):  
Adam Perricone ◽  
Rachel Geller ◽  
Marina Mosunjac
Keyword(s):  
Human Immunodeficiency Virus ◽  
Fine Needle Aspiration ◽  
Hodgkin’S Lymphoma ◽  
Granulomatous Inflammation ◽  
Needle Aspiration ◽  
Hodgkin's Lymphoma ◽  
Potential Confounder ◽  
Fine Needle ◽  
Immunodeficiency Virus

Cytodiagnostic Sensitivity of Fine Needle Aspiration Biopsy for Hodgkin’s Lymphoma Is Decreased in Patients with Human Immunodeficiency Virus Infection

2019 ◽  
Vol 63 (5) ◽  
pp. 352-360 ◽  
Author(s):  
Adam J. Perricone ◽  
Mohammad K. Mohammad ◽  
Rachel L. Geller ◽  
Marina B. Mosunjac
Keyword(s):  
Fine Needle Aspiration ◽  
Hodgkin’S Lymphoma ◽  
Needle Aspiration ◽  
Diagnostic Sensitivity ◽  
Hodgkin's Lymphoma ◽  
P Value ◽  
Hiv Patients ◽  
Female Ratio ◽  
Fine Needle ◽  
Significant Difference

Objective: We aimed to evaluate the sensitivity of fine needle aspiration (FNA) for the diagnosis of Hodgkin’s lymphoma (HL) in HIV-infected patients. Study Design: An electronic search was conducted to retrospectively identify patients diagnosed with HL who underwent FNA followed by confirmatory biopsy. FNAs were categorized as negative, atypical/suspicious/positive, or nondiagnostic. Diagnostic sensitivity in HIV+ and HIV– patients was statistically compared via Fisher’s exact test, with a p value <0.05 considered significant. Results: Thirty-six patients meeting inclusion criteria were identified (24 HIV– and 12 HIV+). Average age was 36.0 ± 11.5 and 36.5 ± 7.4 years (means ± SD) in HIV– and HIV+ patients, respectively. The male-to-female ratio was 1.4:1 in HIV– patients versus 3:1 in HIV+ patients. Among these 36 patients, a total of 42 FNAs were performed. Overall sensitivity of FNA was 66.7% (95% confidence interval: 52.4–80.9%). When stratified by HIV status, a statistically significant difference in FNA sensitivity was detected, as sen­sitivity was 84.6% (70.8–98.4%) in HIV– patients versus only 37.5% (13.8–61.2%) in HIV+ patients (p =0.003). Conclusion: The diagnostic sensitivity of FNA biopsy was significantly attenuated in the HIV+ cohort. In HIV-infected patients presenting with lymphadenopathy, increased clinical suspicion of HL is critical to avoid misdiagnosis.

Human Immunodeficiency Virus Lymphadenitis Patterns on Fine-Needle Aspiration Cytology

2016 ◽  
Vol 61 (1) ◽  
pp. 34-38 ◽  
Author(s):  
Mona Agnihotri ◽  
Leena Naik ◽  
Sachin Chaudhari ◽  
Kanchan Kothari
Keyword(s):  
Human Immunodeficiency Virus ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Cell Counts ◽  
Immunodeficiency Virus ◽  
Needle Aspiration Cytology ◽  
Cd4 Cell

Objective: The aim of this work was to study the microscopic patterns of human immunodeficiency virus (HIV) lymphadenitis on fine-needle aspiration cytology (FNAC) and correlate them with cluster of differentiation 4 (CD4) counts. Study Design: A retrospective study of known HIV-positive patients who underwent lymph node FNAC over a period of 5 years (2009-2013) was undertaken. The cytology slides were retrieved and reviewed. Out of 317 cases, 38 (11.7%) were diagnosed as HIV lymphadenitis. We analysed the cytomorphological patterns of HIV lymphadenitis and correlated them with the CD4 cell counts. Results: Smears of HIV lymphadenitis were classified akin to histology patterns (A, B, and C) depending on cellularity, number of tingible body macrophages, mitosis, apoptotic bodies, plasma cells, Warthin-Finkeldey giant cells, and proliferating blood vessels. Thirty-one cases showed pattern A, 3 showed pattern B, and 4 were of pattern C. Pattern A had the highest CD4 cell count. Conclusion: Histologic patterns of HIV lymphadenitis are recognisable on FNAC smears. These can offer a clue to the diagnosis and guide further workup, even in the absence of history. The changes can mimic those of the infective lymphadenitis, Castleman disease, and lymphoma. Hence, the clinical history, serological correlation, and awareness of cytomorphology can aid the correct diagnosis.

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