A STUDY ON USE OF FNAC FOR THE DIAGNOSIS OF LYMPHADENOPATHY IN HIV POSITIVE PATIENTS COMPARED TO CONVENTIONAL BIOPSY AND CORRELATION OF FINDINGS WITH CD4 COUNT

BACKGROUND: Lymphadenopathy is a common clinical presentation in HIV/AIDS patients and conventional lymph node biopsy is the standard procedure for the diagnosis of this condition but the procedure incurs a high risk for healthcare providers. OBJECTIVES: The aim of this study was to analyze the cytological patterns of lymph node lesions in HIV/AIDS patients and to compare the results of Fine Needle Aspiration Cytology (FNAC) with conventional lymph node biopsy, along with the correlation of findings with CD4 count. MATERIALS AND METHODS: This study is a prospective comparison of an alternative procedure for the diagnosis of lymph node lesions in HIV/AIDS patients, Fine Needle Aspiration Cytology (FNAC), with the conventional method. The study population comprises 73 HIV/AIDS patients who attended the Department of medicine (ART centre), N.S.C.B Medical College Jabalpur. Aspirates were stained routinely with haematoxylin and eosin, Wrights and Ziehl-Neelsen stains. Special stains were done in selected cases. RESULTS: Cytological diagnosis included reactive (46. 6%), tuberculous (31.5%), non-specific chronic granulomatous (8.2%), suppurative (9.5%), Hodgkins lymphoma (1.4%), Suspicious Non- Hodgkins lymphoma n (1.4%), Smear inadequate (1.4%). Reactive and tuberculous lesions were further categorized. Each lesion was correlated with clinical details and CD4 counts. AFB grading was done on Ziehl-Neelsen stained smears in tuberculous lymphadenitis cases. CONCLUSION: Fine Needle Aspiration Cytology of lymph node is very useful for segregating lymphadenopathy cases in HIV/AIDS patient. FNAC is practical, convenient, safe, and relatively painless. Correlation of lesions with mean CD4 count and AFB grading reflects immunity, stage of disease and disease activity.