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The utility of fine needle aspiration in HIV positive children
1Cytology Unit, National Health Laboratory Service and University of Witwatersrand, Johannesburg, South Africa. pamela.michelow@nhls.ac.za
Insights
Fine needle aspiration (FNA) is a valuable diagnostic tool for mass lesions in children with human immunodeficiency virus (HIV). This procedure aids in rapid diagnosis, often avoiding surgery and facilitating timely treatment.
Area of Science:
- Pediatric Infectious Diseases
- Oncology
- Diagnostic Cytopathology
Background:
- Mass lesions are common in children with human immunodeficiency virus (HIV).
- Accurate and timely diagnosis is crucial for effective management.
- Fine needle aspiration (FNA) is a minimally invasive diagnostic technique.
Purpose of the Study:
- To evaluate the spectrum of diseases presenting as mass lesions in HIV-positive children.
- To assess the diagnostic accuracy and adequacy of FNA in this population.
- To determine the utility of FNA in guiding patient management.
Main Methods:
- A retrospective review of 95 FNAs performed in 91 HIV-positive children (aged ≤15 years) between January 1997 and December 2002.
- Analysis of lesion location, cytological diagnoses, and adequacy of samples.
- Correlation of FNA findings with clinical outcomes where available.
Main Results:
- Head and neck masses were the most frequent (58.9%), followed by axillary masses (25.3%).
- Common diagnoses included reactive lymphadenopathy (42 cases), mycobacterial infection (22 cases), and abscess (4 cases).
- Malignancies such as non-Hodgkin's lymphoma (5 cases) and Kaposi sarcoma (4 cases) were also identified. Eight FNAs (8.4%) were inadequate.
Conclusions:
- FNA is a worthwhile procedure for diagnosing mass lesions in HIV-positive children, offering rapid diagnoses.
- The technique frequently obviates the need for surgical intervention, enabling prompt treatment.
- Ancillary studies are important for diagnosis, and universal safety precautions are essential.
Objective:
To determine the spectrum of disease, diagnostic accuracy and adequacy of fine needle aspirates (FNA) in human immunodeficiency virus (HIV) positive children who present with mass lesions.
Methods:
Between January 1997 and December 2002, 95 FNAs were performed in 91 children aged 15 years and younger who were known to be infected with the human immunodeficiency virus (HIV).
Results:
Head and neck masses including salivary gland swellings were the most common presentation (58.9%) followed by axillary masses (25.3%). Groin masses were aspirated in six children, flank and abdominal masses in four children, buttock masses in three children, a chest wall mass in one child and a sonar guided FNA of a lung mass in one child. Eight FNAs (8.4%) proved inadequate. Reactive lymphadenopathy was diagnosed in 42 cases, mycobacterial infection in 22, four children were diagnosed with abscess, one child had a fungal infection and five were found to have non-Hodgkin's lymphoma. There were four cases each of lymphoepithelial lesion and Kaposi sarcoma. There was one case each of nephroblastoma, rhabdomyosarcoma, myeloma, melanotic progonoma and spindle cells, not otherwise specified.
Conclusion:
Fine needle aspiration in HIV positive children is a worthwhile procedure and in most instances allows a rapid diagnosis obviating the need for surgery and enabling swift treatment to be undertaken where necessary. Ancillary studies form an important diagnostic component. Universal safety precautions must be strictly adhered to.
