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AFB grading on Z-N stained smears. 2a. Grade 1 + (ZN stain 1000X). 2b. Grade 2+ (ZN stain 1000X). 2c. Grade 3+ (ZN stain 400X). 2d. Grade 3+ (ZN stain 1000X).
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Background & objectives:
Lymphadenopathy and haematological alterations are the earliest manifestations with other associated opportunistic infections and malignancies. Hence, there is a need for simple investigations like fine needle aspiration cytology (FNAC) for evaluation of HIV lymphadenopathy and a haemogram to interpret the haematological al...
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Context 1
... The present study showed grade 2+ as the predominant pattern (62.96%). Z-N grade 1+ was seen in 6 (11.11%) and grade 3+ in 14 (25.92%) patients. CD4 counts in tuberculous lymphadenitis patients were found to be decreased with increased bacillary load. Mean CD4 counts in patients with CN were 99.6-103.7, 105.2 in CN-ECG and 139.5 cells/µl in ECG (Fig. ...Similar publications
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Citations
... Among the various screening tests for tuberculosis like CBNAAT, FNAC and radiodiagnosis, FNAC is cost effective, efficient in arriving at early diagnosis. 5 Tubercular lymphadenitis was the most common diagnosis in our study and in those conducted by Tirumalasetti and Latha, 6 Agravat et al., 7 Jayaram and Chew, 8 Shenoy et al., 9 and Deshmukh et al. 6 Cervical lymph nodes were most commonly affected in 60 patients. Similar findings were recorded by others. ...
... Among the various screening tests for tuberculosis like CBNAAT, FNAC and radiodiagnosis, FNAC is cost effective, efficient in arriving at early diagnosis. 5 Tubercular lymphadenitis was the most common diagnosis in our study and in those conducted by Tirumalasetti and Latha, 6 Agravat et al., 7 Jayaram and Chew, 8 Shenoy et al., 9 and Deshmukh et al. 6 Cervical lymph nodes were most commonly affected in 60 patients. Similar findings were recorded by others. ...
... Similar findings were recorded by others. 6 The most common cytological diagnosis was tuberculous lymphadenitis (41.8%); similar to observations made in studies by others. 6 Cervical lymph node was the predominant among tuberculous lymphadenitis. ...
... We found lymph nodes showing epithelioid granuloma with necrosis to be the commonest 22 (50%) cases, followed by lymph nodes showing predominantly necrotic pattern 19 X 3 GJRA -GLOBAL JOURNAL FOR RESEARCH ANALYSIS VOLUME-9, ISSUE-6, JUNE-2020 In the present study 09 (11.40%) cases were labeled as suppurative lymphadenitis. Similar ndings were reported by 5 Tirumalasetti et al (2014) ...
... patients of suppurative lymphadenitis, the mean CD4 count for these patients was 227.77/µl. Our ndings were in agreement with5 18 the ndings of Tirumalasetti et al (2014) , Ratan et al (2014) 14 and Nasser et al (2017) who found the mean CD4 count associated with suppurative lymphadenitis to be 181.65/µl, 189.71/µl and 181.4/µl respectively. ...
... Therefore, patients with cervical lymphadenopathy must undergo FNAC and cell block, if required, for the diagnosis and accordingly, the next step of the therapeutic approach can be planned. The HIV positive patient group comprised more males than females, which is consistent with other studies [6,7]. However, in HIV negative patients, males were very few in number; the proportion was significantly lower than that in HIV-infected patients, thus indicating that HIV infection mainly affects males. ...
... The most common cytomorphological category of tuberculous lymphadenitis in the present study was caseous necrosis with epithelioid cell granuloma and multinucleated giant cells. Necrotizing suppurative inflammation and neutrophilic aggregates were also observed, which is consistent with some studies [6,7,18]. ...
Background:
Cervical lymphadenopathy refers to a frequently observed clinical presentation in numerous pathological conditions. A wide spectrum of diseases can cause cervical lymphadenopathy, irrespective of the fact that the patients are infected with HIV or not. The present study focuses on validating whether the causes of cervical lymphadenopathy differ significantly in HIV and non-HIV patients by using fine-needle aspiration cytology (FNAC) combining cell block.
Methods:
A total of 589 patients with cervical lymphadenopathy were recruited in the FNA clinic. The samples were obtained by an auto-vacuumed syringe that benefited the sampling more materials. The cytological smears were prepared by Hematoxylin and Eosin (HE), Periodic Acid Schiff (PAS), Gomori's methenamine silver (GMS) and acid-fast staining. Cell blocks were made if required, and immunohistochemistry stain was performed on the cell block section.
Results:
The study found 453 (76.9%) patients with HIV and 136 (23.1%) patients without HIV infection. The average age of HIV-infected patients was 34.8 ± 10.2 years, which was significantly lower than that of non-HIV-infected patients (42.9 ± 18.1 years) (p < 0.01). Of all patients infected with HIV, 390 (86.1%) were males. This proportion was significantly higher than that of non-HIV-infected patients [65/136 (47.8%)] (p < 0.01). The major causes of cervical lymphadenopathy in HIV positive patients were mycobacterial infection (38.4%), reactive hyperplasia (28.9%), non-specific inflammation (19.9%), and malignant lesions (4.2%). In contrast, the most common causes in HIV negative patients were reactive hyperplasia (37.5%), malignancy (20.6%), non-specific inflammation (19.1%) and mycobacterial infection (12.5%). Opportunistic infections such as non-tuberculous mycobacteria (4.2%), cryptococcosis (1.5%), Talaromyces marneffei (1.5%) and other fungi (0.4%) were found only in HIV-infected individuals. Non-Hodgkin's lymphoma (2.4%) was the most common malignant lesion in patients with HIV infection, followed by Kaposi's sarcoma (0.9%) and metastatic squamous cell carcinomas (0.7%). However, the most common malignancy in non-HIV-infected patients was metastatic carcinomas (14%) including small cell carcinomas, adenocarcinomas, squamous cell carcinomas and hepatocellular carcinoma, which were noticeably greater than the HIV patients (p < 0.01).
Conclusions:
There were significantly different causes of cervical lymphadenopathy in HIV infected and non-HIV infected patients. FNAC was a useful diagnostic method for differential diagnosis of cervical lymphadenopathy.
... The HIV positive patient group comprised more males than females, which is consistent with other studies [6][7]. However, in HIV negative patients, males were very few in number; the proportion was significantly lower than that in HIV-infected patients, thus indicating that HIV infection mainly affects males. ...
... The most common cytomorphological category of tuberculous lymphadenitis in the present study was caseous necrosis with epithelioid cell granuloma and multinucleated giant cells. Necrotizing suppurative inflammation and neutrophilic aggregates were also observed, which is consistent with some studies [6,7,18]. ...
Background Cervical lymphadenopathy refers to a frequently observed clinical presentation in numerous pathological conditions. A wide spectrum of diseases can cause cervical lymphadenopathy, irrespective of the fact that the patients are infected with HIV or not. The present study focuses on validating whether the causes of cervical lymphadenopathy differ significantly in HIV and non-HIV patients by using fine-needle aspiration cytology (FNAC) combining cell block. Methods A total of 589 patients with cervical lymphadenopathy were recruited in the FNA clinic. The samples were obtained by an auto-vacuumed syringe that benefited the sampling more materials. The cytological smears were prepared by Hematoxylin and Eosin (HE), Periodic Acid Schiff (PAS), Gomori’s methenamine silver (GMS) and acid-fast staining. Cell blocks were made if required, and immunohistochemistry stain was performed on the cell block section. Results The study found 453 (76.9%) patients with HIV and 136 (23.1%) patients without HIV infection. The average age of HIV-infected patients was 34.8 ±10.2 years, which was significantly lower than that of non-HIV-infected patients (42.9 ±18.1 years) (p
... The HIV positive patient group comprised more males than females, which is consistent with other studies [6][7]. However, in HIV negative patients, males were very few in number; the proportion was significantly lower than that in HIV-infected patients, thus indicating that HIV infection mainly affects males. ...
... The most common cytomorphological category of tuberculous lymphadenitis in the present study was caseous necrosis with epithelioid cell granuloma and multinucleated giant cells. Necrotizing suppurative inflammation and neutrophilic aggregates were also observed, which is consistent with some studies [6,7,18]. ...
Background
Cervical lymphadenopathy refers to a frequently observed clinical presentation in numerous pathological conditions. A wide spectrum of diseases can cause cervical lymphadenopathy, irrespective of the fact that the patients are infected with HIV or not. The present study focuses on validating whether the causes of cervical lymphadenopathy differ significantly in HIV and non-HIV patients by using fine-needle aspiration cytology (FNAC) combining cell block.
Methods
A total of 589 patients with cervical lymphadenopathy were recruited in the FNA clinic. The samples were obtained by an auto-vacuumed syringe that benefited the sampling more materials. The cytological smears were prepared by Hematoxylin and Eosin (HE), Periodic Acid Schiff (PAS), Gomori’s methenamine silver (GMS) and acid-fast staining. Cell blocks were made if required, and immunohistochemistry stain was performed on the cell block section.
Results
The study found 453 (76.9%) patients with HIV and 136 (23.1%) patients without HIV infection. The average age of HIV-infected patients was 34.8 ±10.2 years, which was significantly lower than that of non-HIV-infected patients (42.9 ±18.1 years) (p<0.01). Of all patients infected with HIV, 390 (86.1%) were males. This proportion was significantly higher than that of non-HIV-infected patients [65/136 (47.8%)] (p<0.01). The major causes of cervical lymphadenopathy in HIV positive patients were mycobacterial infection (38.4%), reactive hyperplasia (28.9%), non-specific inflammation (19.9%), and malignant lesions (4.2%). In contrast, the most common causes in HIV negative patients were reactive hyperplasia (37.5%), malignancy (20.6%), non-specific inflammation (19.1%) and mycobacterial infection (12.5%). Opportunistic infections such as non-tuberculous mycobacteria (4.2%), cryptococcosis (1.5%), Talaromyces marneffei (1.5%) and other fungi (0.4%) were found only in HIV-infected individuals. Non-Hodgkin’s lymphoma (2.4%) was the most common malignant lesion in patients with HIV infection, followed by Kaposi's sarcoma (0.9%) and metastatic squamous cell carcinomas (0.7%). However, the most common malignancy in non-HIV-infected patients was metastatic carcinomas (14%) including small cell carcinomas, adenocarcinomas, squamous cell carcinomas and hepatocellular carcinoma, which were noticeably greater than the HIV patients (p<0.01).
Conclusions
There were significantly different causes of cervical lymphadenopathy in HIV infected and non-HIV infected patients. FNAC was a useful diagnostic method for differential diagnosis of cervical lymphadenopathy.
... In HIV patients, the increased number of suppurative process can be attributed to decreased immunity and increased infection risk.8 Tirumalasetti et al10 reported the mean CD4 count in this category of lesions as 181.65 cells/μl when compared to 424.7 cells/μL in the present study. Cryptococcosis is a systemic life-threatening opportunistic fungal infection encountered in HIV II. ...
... The same authors have reported that the CD4 count was less than 100 cells/μl in all these malignant lesions. 10 When the CD4 count was compared between the diagnostic categories, it was found that the lowest CD4 count was encountered in cryptococcal lymphadenitis followed by reactive lymphadenitis and was higher in suppurative lymphadenitis cases. However, CD4 count was not statistically significant. ...
Background:
India, being a developing country, harbors the third largest human immunodeficiency virus (HIV)-infected population in the world, and HIV-associated lymphadenopathy is commonly encountered. HIV lymphadenopathy is more commonly generalized and pathology ranges from reactive lymphoid hyperplasia to infections like tuberculosis to neoplasms such as lymphoma and Kaposi sarcoma. The study intended to assess the utility of fine-needle aspiration (FNA) cytology in HIV lymphadenopathy.
Materials and methods:
A retrospective FNA slide review of HIV-infected cases with lymphadenopathy received over a period of 2 years in the cytopathology department was performed. The clinicopathological characteristics, absolute lymphocyte count (ALC), and CD4 counts were analyzed.
Results:
Seventy-nine lymph node aspirates were received from HIV patients over 2 years. The mean age at presentation was 39 years with a male:female ratio of 2.4:1. Cervical lymph nodes (62%) were more commonly affected. Tuberculous lymphadenitis was the commonest lesion (41.8%), followed by reactive lymphadenitis (24%), nonspecific granulomatous lymphadenitis (14%), suppurative lymphadenitis (8%), cryptococcal lymphadenitis (2%), lymphoma (9%), and metastasis (1%).
Conclusion:
Lymph node FNA in HIV/AIDS is not only useful in identifying those cases that require further evaluation, but also aids in categorizing various etiologies such as opportunistic infections, non-neoplastic, and neoplastic lesions. FNA is a less expensive, expeditious minimally invasive method for an early diagnosis that abets in deciding the treatment strategy, thus curtailing the associated morbidity and mortality.
... This is in accordance with previous studies in India that more than 40 (40-50 years) are more likely to experience HIV lymphadenitis than those aged 20-40 years, because the age of 40-50 has a lower endurance compared to young age and organs already cannot perform its function perfectly (Thakkar, Ghaisas, & Singh, 2016). But this is different from the results of research conducted by Neelima, et al. that HIV lymphadenitis is more frequent at the age of 21-40 years because this behavior is relatively young to do something that makes it easier to become infected with the HIV virus, for example by free sex or by exchanging drug needles (Tirumalasetti & Latha, 2014). The age distribution of other microorganism lymphadenitis sufferers in this study from the highest sequence was 15-24 years old with 10 subjects (28.6%), second place 25-44 years old with 9 subjects (25.7%), age 5-14 years is ranked third, as many as 7 subjects (20.0%), while ages 0-4 years as many as 6 subjects (17.1%), ages 45-64 years as many as 3 subjects (8.6% ), and there are no other microorganism lymphadenitis sufferers at the age of> 65 years. ...
... These results are in line with the theory that HIV lymphadenitis more often affects the neck or more precisely in supra clavicula which has a close association with malignancy (Oehadian, 2013). These results are also in accordance with previous studies conducted in India, the colli region which was more often affected by HIV lymphadenitis (Tirumalasetti & Latha, 2014). ...
Background: Lymphadenitis is an inflammation of the lymph nodes caused by a variety of microorganisms such as Mycobacterium tuberculosis, human immunodeficiency virus (HIV), and other microorganisms. Patient characteristics lymphadenitis diverse views on the etiology, age, gender, and lymph nodes affected.Purpose: The purpose of this study was to describe the characteristics of patients with lymphadenitis.Methods: The design of this study is descriptive cross sectional method is done by looking at medical records of patients in Dr. H. Abdul Moeloek hospital Bandar Lampung 2015. The samples were taken using stratified random sampling technique so that 161 samples used in this study.Results: The results showed the frequency distribution of patients with tuberculous lymphadenitis is the highest (57.14%), lymphadenitis other microorganisms (21.74%), and HIV lymphadenitis (21.12%). The frequency distribution of TB lymphadenitis patient age was 15-24 years (45.7%), patients with HIV lymphadenitis most at the age of 45-64 (29.4%), while the age of the patient lymphadenitis other microorganisms highest in the 15-24 age (28 , 6%). The frequency distribution of TB lymphadenitis gender, HIV and most were female (58.7% and 52.9%), while the frequency distribution of the sexes in most other microorganisms lymphadenitis patients were male (54.3%).Conclusion: The frequency distribution locations lymphadenitis TB, HIV and other microorganisms most was the neck (regio colli) (96%, 55.9% and 57.1%).
... 14,15 In developing countries like India, Malaysia, and Brazil, the prevalence of tuberculosis was high as reported by many studies. 12,[16][17][18][19] In the present research prevalence of tuberculosis was comparable with the studies conducted in developing countries. ...
... The prevalence of malignancy in our study was higher compared to previous FNAC studies in India and in Malaysia. 12,[16][17][18] This can be explained by confirmatory diagnosis obtained by excision biopsy after HPE due to adequate specimen and with preserved morphology. Higher prevalence of malignancy was reported in studies conducted in USA. ...
Background: One of the most common manifestations in human immunodeficiency virus (HIV) is generalized lymphadenopathy. Biopsy of these nodes can help in diagnosing associated conditions. Biopsy of clinically non-palpable lymph nodes can help physician to obtain an early diagnosis of associated diseases in people living with HIV (PLHIV). Present research was undertaken to study diagnostic yield of sonologically detected peripheral lymph node biopsy in symptomatic PLHIV.Methods: One hundred ten PLHIV above age of 18 years referred to surgery department for excision biopsy of sonologically detected peripheral lymph nodes were included. Specimen was sent in normal saline to laboratory for testing and part of the specimen was fixed in formalin for further evaluation. Gram stain, Zeil Nelson stain, histopathological examination and genotype MTBDR plus test were conducted. Comparison of quantitative variables and qualitative variables was done by using Kruskal wallis test and Chi-square test / Fisher’s exact test respectively.Results: Most common diagnosis obtained was tuberculous lymphadenopathy followed by reactive hyperplasia. Significantly higher percentage of patients having weight loss was diagnosed with tuberculous lymphadenopathy. Percentage of tuberculous lymphadenopathy patients was higher in patients who were not on anti-retroviral therapy (ART) as compared to those who were on ART. Median duration of HIV in tuberculosis lymphadenopathy patients was less as compared to patients with malignancy. Sensitivity, and specificity was 91.7%, and 61.5% respectively for diagnostic yield of USG in non-palpable lymph nodes.Conclusions: USG is a sensitive tool for early detection of clinically non-palpable pathological lymph nodes in symptomatic PLHIV.
... [35] Similar study from Hong Kong had reported the prevalence of cervical lymph node tuberculosis as over 60 percent. [39] The most common site of lymphadenopathy was cervical (left posterior cervical group) in 124 patients (81.04%), followed by axillary lymphadenopathy in 19 (12.4%).The distribution of cytological diagnosis of various HIV lymphadenopathies included tuberculous lymphadenitis in 54 cases (41.8%), which was the most common cytological diagnosis.CD4 counts in tuberculous lymphadenitis patients were found to be decreased with increased bacillary load. ...
Tuberculosis is a widespread, fatal disease caused by Mycobacterium tuberculosis. Tuberculosis typically involves the lungs, but can affect other parts of the body. One-third of the world's population is thought to have been infected with M with new infections occurring in about 1% of the population each year. More people in the developing world contract tuberculosis because of a poor immune system, largely due to high rates of HIV infection. The current worldwide estimate of the number of cases of HIV infection among adults are 38.6 million, one third of them co-infected with M tuberculosis. Our study showed pleural effusion was the most common presentation in nonHIV group where as cervical lymphadenopathy in HIV group with no difference in occurrence of INH/Rifampicin resistance. There is no statistical difference of sputum positivity in AFB between the groups and without significant correlation of CD4 count among HIV group.
... Laboratory detection of bovine TB is a challenge, particularly in low income countries. Microscopy for mycobacteria on the FNA is the initial diagnostic procedure for lymphadenitis in Mozambique; although it does not differentiate between M. tuberculosis and M. bovis, it is Table 2 Shared Types and orphans description in the study, their percentage and lineage within the study *Newly created SITs, either within the present study or after a match with an orphan in the database **Orphans, unique in the SITVIT2 database considered a reliable TBLN diagnostic method, including in HIV positive individuals [26][27][28][29]. Molecular typing methods for M. tuberculosis complex detection on FNA specimen are costly and require technical expertise, therefore, are not implemented as a routine method in the country, making the detection of bovine TB difficult. ...
The zoonosis bovine tuberculosis (TB) is known to be responsible for a considerable proportion of extrapulmonary TB. In Mozambique, bovine TB is a recognised problem in cattle, but little has been done to evaluate how Mycobacterium bovis has contributed to human TB. We here explore the public health risk for bovine TB in Maputo, by characterizing the isolates from tuberculous lymphadenitis (TBLN) cases, a common manifestation of bovine TB in humans, in the Pathology Service of Maputo Central Hospital, in Mozambique, during one year.
Among 110 patients suspected of having TBLN, 49 had a positive culture result. Of those, 48 (98 %) were positive for Mycobacterium tuberculosis complex and one for nontuberculous mycobacteria. Of the 45 isolates analysed by spoligotyping and Mycobacterial Interspersed Repetitive Unit – Variable Number Tandem Repeat (MIRU-VNTR), all were M. tuberculosis. No M. bovis was found.
Cervical TBLN, corresponding to 39 (86.7 %) cases, was the main cause of TBLN and 66.7 % of those where from HIV positive patients.
We found that TBLN in Maputo was caused by a variety of M. tuberculosis strains. The most prevalent lineage was the EAI (n = 19; 43.2 %). Particular common spoligotypes were SIT 48 (EAI1_SOM sublineage), SIT 42 (LAM 9), SIT 1 (Beijing) and SIT53 (T1), similar to findings among pulmonary cases.
M. tuberculosis was the main etiological agent of TBLN in Maputo. M. tuberculosis genotypes were similar to the ones causing pulmonary TB, suggesting that in Maputo, cases of TBLN arise from the same source as pulmonary TB, rather than from an external zoonotic source. Further research is needed on other forms of extrapulmonary TB and in rural areas where there is high prevalence of bovine TB in cattle, to evaluate the risk of transmission of M. bovis from cattle to humans.
