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Ex Vivo Infection of Human Lymphoid Tissue and Female Genital Mucosa with Human Immunodeficiency Virus 1 and Histoculture
Published on: October 12, 2018
Immunocytochemical analysis of lymph node aspirates in patients with human immunodeficiency virus infection
Insights
Fine needle aspiration with immunocytochemistry aids in diagnosing lymphadenopathy in HIV patients. This method helps differentiate conditions like lymphomas and infections, improving diagnostic accuracy.
Area of Science:
- Immunology
- Oncology
- Infectious Diseases
Background:
- Lymphadenopathy is common in Human Immunodeficiency Virus (HIV) positive patients.
- Accurate diagnosis is crucial for effective management of HIV-associated conditions.
Purpose of the Study:
- To evaluate the utility of fine needle aspiration (FNA) with immunocytochemistry for diagnosing lymphadenopathy in HIV-positive individuals.
- To assess the diagnostic performance of the alkaline phosphatase-antialkaline phosphatase (APAAP) method in differentiating various causes of lymphadenopathy.
Main Methods:
- Investigated 34 HIV-positive patients with lymphadenopathy using FNA.
- Performed cytological analysis including immunocytochemical investigation (APAAP method).
- Confirmed cytological diagnoses with lymph node biopsy.
Main Results:
- Fifteen aspirates showed follicular hyperplasia with B cell predominance, lacking light chain restriction.
- Ten cases of B cell non-Hodgkin's lymphoma (Burkitt's and immunoblastic) were identified, with 90% showing monoclonal light chain restriction.
- Other diagnoses included mycobacterial infections, cystic lesions, and Kaposi's sarcoma (requiring histology for extent).
Conclusions:
- Immunocytological investigation of lymph node aspirates is a valuable tool for evaluating lymphadenopathy in HIV-positive patients.
- This technique aids in distinguishing between reactive hyperplasia, lymphomas, and infections.
- FNA with immunocytochemistry complements biopsy in the diagnostic workup.
Abstract:
Thirty four patients positive for human immunodeficiency virus (HIV) who had lymphadenopathy were investigated using fine needle aspiration. Cytological analysis included immunocytochemical investigation with the alkaline phosphatase-antialkaline phosphatase (APAAP) method. All patients had confirmation of cytological diagnosis by lymph node biopsy. Fifteen aspirates with follicular hyperplasia were evaluated. Eleven patients showed B cell predominance. The B cell population did not show light chain restriction. Ten patients with B cell non-Hodgkin's lymphoma (five with Burkitt's lymphoma and five with B cell immunoblastic lymphoma) were investigated. Nine out of 10 cases were monoclonal with respect to their light chain determinants; only one case with Burkitt's lymphoma with partial lymph node metastasis did not show light chain restriction. The cytological diagnosis included two mycobacterial infections and four cystic lesions. Histological investigation was necessary to diagnose the extent of lymph node disease caused by Kaposi's sarcoma. These findings indicate that the immunocytological investigation of lymph node aspirates is useful for evaluating lymphadenopathy in HIV positive patients.
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