Fine-needle aspiration of peripheral lymph nodes in patients with tuberculosis and HIV

Previous studies of fine-needle aspiration (FNA) specimens from lymph nodes of patients with tuberculosis (TB) and infection with the human immunodeficiency virus (HIV) have often involved small numbers of specimens and have produced conflicting results. We reviewed 93 FNA specimens from peripheral lymph nodes in a consecutive series of 79 patients with TB to compare results for patients with and without HIV infection. The 45 patients with HIV infection in the series were more frequently male, more likely to have negative results on a purified protein derivative tuberculin skin test, and they had more disseminated disease. Granulomatous inflammation, a positive result on a culture, acid-fast bacilli, or necrosis was found in 71% of the studies. Identification of granulomatous inflammation occurred at a similar rate in FNA specimens from patients with HIV infection (16%) and without HIV infection (21%; P = .56). Necrosis was the sole reported finding in a significant subset of cases (16%), occurring in patients with and patients without HIV infection. FNA of peripheral lymph nodes of patients with TB was an effective diagnostic test. Granulomatous inflammation and other FNA findings in peripheral lymph nodes of patients with TB were similar in those with and those without HIV infection.