MR of head and neck adenopathy in asymptomatic HIV-seropositive men

Adenopathy is a well-known component of AIDS-related complex. Our goal was to determine whether asymptomatic HIV-infected persons have characteristic findings of head and neck adenopathy on MR imaging and whether there is an association between the MR findings and the CD4 lymphocyte counts.

We blindly and retrospectively evaluated the distribution and size of lymphadenopathy seen on screening MR examinations that were performed on 50 asymptomatic HIV-positive male subjects and 50 age-matched HIV-negative control subjects. We also correlated the imaging findings in HIV-seropositive and -seronegative subjects with their CD4 counts.

The HIV-positive subjects had a higher incidence of adenopathy compared with the controls. Statistically significant differences were found between the groups in size and number of neck lymph nodes, thickness of the adenoids, size of high, deep cervical-retropharyngeal lymph nodes, and presence of parotid abnormalities. We found a correlation between increasing lymph node size and decreasing CD4 levels.

We conclude that HIV-positive asymptomatic patients have a high incidence of head and neck abnormalities including lymphadenopathy, and alteration in their CD4 counts not commonly seen in seronegative control subjects.