Acquired immune deficiency syndrome. A surgical perspective

Eighty-nine lymph node biopsies were performed on 82 patients with lymphadenopathy, immunosuppression, and possible acquired immune deficiency syndrome. The 21 patients with diagnoses of lymphoma or Kaposi's sarcoma were older, had more sexual contacts, and were sexually active for more years than patients with benign diagnoses. Cytomegalovirus and Epstein-Barr viral titers were elevated in both groups but were not significantly different in the benign and malignant groups. Skin flora were cultured from lymph node tissue in 24.7% of the patients. Two patients (2.5%) had wound infections with the same bacterium present in the lymph node culture, while 66 patients initially had two different benign pathologic patterns. Fifty-six patients had explosive follicular hyperplasia, and ten had follicular involution. Four of the patients with follicular involution and one with follicular hyperplasia subsequently had malignant tumors.