A distinctive cytologic pattern for diagnosing tuberculous lymphadenitis in AIDS

Area of Science:

• Infectious Diseases
• Oncology
• Pathology

Background:

• Tuberculous lymphadenitis (TL) is a frequent opportunistic infection in individuals with human immunodeficiency virus (HIV).
• Accurate and timely diagnosis of TL is crucial for effective management in HIV-infected populations.

Purpose of the Study:

• To evaluate the diagnostic utility of fine-needle aspiration biopsy (FNAB) for tuberculous lymphadenitis (TL) in HIV-infected patients.
• To assess the significance of different cytologic patterns, including necrotizing lymphadenitis (NL), in diagnosing TL.

Main Methods:

• Fine-needle aspiration biopsy (FNAB) was performed on enlarged lymph nodes in 57 HIV-infected patients.
• Cytologic patterns were analyzed, and results were correlated with microbiologic confirmation and clinical data.
• Histopathologic examination and microbiologic methods (Ziehl-Neelsen stain, Löwenstein culture) were used for confirmation.

Main Results:

• Twenty-one patients were diagnosed with TL based on FNAB findings.
• Cytologic patterns observed included granulomatous lymphadenitis (GL), necrotizing granulomatous lymphadenitis (NGL), and necrotizing lymphadenitis (NL).
• The NL pattern, observed in 12 patients, showed high diagnostic value, with 11 cases confirmed microbiologically and one by subsequent biopsy showing NGL.

Conclusions:

• Fine-needle aspiration biopsy (FNAB) is a valuable, cost-effective, and safe diagnostic method for TL in HIV-infected patients.
• The necrotizing lymphadenitis (NL) cytologic pattern on FNAB is highly suggestive of TL and warrants initiation of antituberculous treatment.