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HIV Infection: Analysis of Mammographic Findings
Stephen B. Solomon1, Olga M. B. Gatewood, Rachel F. Brem
1Division of Breast Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Insights
Mammograms of HIV-infected women show larger, denser axillary lymph nodes compared to controls. These findings, particularly large and dense nodes, can aid in diagnosing HIV infection, as CD4 counts did not correlate.
Area of Science:
- Radiology
- Infectious Diseases
- Oncology
Background:
- Human Immunodeficiency Virus (HIV) infection can affect various organ systems, including the lymphatic system.
- Mammographic screening is crucial for early detection of breast abnormalities.
Purpose of the Study:
- To compare mammographic findings in HIV-infected women and age-matched controls.
- To investigate the correlation between mammographic findings and CD4 counts in HIV-infected patients.
Main Methods:
- A case-control study comparing mammograms of 67 HIV-infected women and 58 age-matched controls.
- Analysis of axillary lymph nodes (number, size, density, bilaterality) and intramammary nodules/calcifications.
- Correlation of mammographic findings with patient CD4 counts.
Main Results:
- Axillary lymph node presence and bilaterality were similar between HIV-positive patients and controls.
- HIV-infected women had statistically larger and denser axillary lymph nodes.
- Benign nodules and calcifications were equally common in both groups; CD4 counts did not correlate with findings.
Conclusions:
- Larger, denser axillary lymph nodes without fatty hila are significant indicators of HIV infection.
- Mammographic features, specifically axillary lymph node characteristics, may assist in considering HIV diagnosis.
Abstract:
The purpose of this study was to compare the mammographic findings of patients with HIV infection and age-matched controls and to correlate these findings in patients with HIV infection to their CD4 counts. A case-control study of the mammograms of 67 HIV-infected women and 58 age-matched controls was performed and compared for any statistically significant differences in the number, size, density, and bilaterality of axillary lymph nodes. Similar analysis of intramammary nodules and calcifications was made. These findings were correlated with the patient's CD4 counts. The presence of axillary nodes and bilaterality of the nodes was equivalent in both HIV-positive patients and controls. However, the nodes of HIV-infected women were statistically larger and denser. When the criteria of large (>/=2 cm), absent, fatty hilum and increased density were used in this study, the presence of HIV infection was high. Benign-appearing nodules and calcifications were equally common in HIV and control patients. CD4 counts did not correlate with any of the axillary node or intramammary nodule features. In patients with large (>/=2 cm), dense axillary nodes without fatty hila, the diagnosis of HIV infection should be considered.
