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Collection, Isolation, and Flow Cytometric Analysis of Human Endocervical Samples
Published on: July 6, 2014
Indications for open cervical node biopsy in HIV-positive patients
F Burton1, M L Patete, W J Goodwin
1Department of Otolaryngology-Head and Neck Surgery, University of Miami/Jackson Memorial Hospital, FL 33101.
Summary
For human immunodeficiency virus (HIV) patients with non-enlarging cervical lymph nodes, open node biopsy is not recommended. Fine-needle aspiration (FNA) may be useful for diagnosing infections but not neoplastic diseases.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Oncology
Background:
- Historically, open node biopsy diagnosed HIV infection before serologic tests.
- Otolaryngologists manage HIV-positive patients with cervical adenopathy.
- The role of fine-needle aspiration (FNA) versus open biopsy for cervical nodes in HIV patients is unclear.
Purpose of the Study:
- To determine the indications for open cervical node biopsy in HIV-positive patients.
- To evaluate the utility of FNA in diagnosing cervical lymphadenopathy in HIV-positive individuals.
Main Methods:
- Retrospective review of 93 consecutive cervical node biopsies (1985-1989).
- Analysis of 20 HIV-positive patients, including 10 with acquired immune deficiency syndrome (AIDS).
- Comparison of FNA results with open biopsy findings.
Main Results:
- Open biopsy is not indicated for HIV/AIDS patients with nontender, nonenlarging nodes (lymphoid hyperplasia).
- FNA diagnosed mycobacterial infections in 4/8 patients; open biopsy added no value.
- FNA failed to diagnose Nocardial infection (2 patients) and neoplastic diseases (2 patients).
Conclusions:
- Cervical node biopsy is unnecessary for HIV/AIDS patients presenting with nontender, nonenlarging nodes.
- FNA has limitations in diagnosing Nocardial infections and cancers in this population.
- Open biopsy remains crucial for diagnosing certain infections and neoplastic conditions in HIV-positive patients with symptomatic cervical adenopathy.
