AEGiS-15IAC: Comparision of fine needle aspiration and excision biopsies in the etiological diagnosis of lymphadenopathy in HIV infected patients who attend Mbarara hospital.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Comparision of fine needle aspiration and excision biopsies in the etiological diagnosis of lymphadenopathy in HIV infected patients who attend Mbarara hospital.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10139)

Mayanja B, Mpagi F, Katabila E
University, Mbarara, Uganda

BACKGROUND: The use of Fine needle aspiration biopsy rather than excision biopsy in diagnosing the cause of lymphadenopathy in HIV/AIDS patients should be adopted in a resource limited hospitals. Fine needle aspiration is quick, cheaper, easier, and less harmful to the patient.

METHODS: The study was done in a Ugandan, rural University Teaching hospital, Mbarara District. The smears and histologies of 104 HIV infected patients were obtained. Cytological smears were stained with two different stains, Giemsa and Ziehl-Neelsen stains. Histological specimens mounted on the slides were stained with Haemotoxylin and Eosin stain and examined microscopically.

RESULTS: The cytological diagnoses of 104 smears included; 46(44.2%) as non specific lymphadenitis, 21(20.2%) as tuberculous lymphadenitis, 2(1.92%) as Kaposi's sarcoma, and 35(33.5%) for others that each included, 1 lymphoma, 32 red blood cells, 1 sarcoidosis, and 1 epidermoid carcinoma. Tuberculous lymphadenitis was the most common condition diagnosed by histology (45.2%), followed by non specific with 27%. The specificities for all different diagnoses ranged from 61.8% to 100%. However, sensitivities were low (12.5% to 60.7%). Tuberculosis showed a sensitivity of 44.6%, non specific with 60.7%. Significant correlation was only with TB lymphadenitis with Kappa 0.4696.

CONCLUSION: Fine neele aspiration biopsy may suffice in the diagnosis of tuberculosis and non specific lymphadenitis but for other diagnoses, open lymph node biopsy is still recommended pending further studies. Fine needle aspiration is a reliable, minimally traumatic, cost-effective method. It is suitable for an initial rapid diagnosis in HIV positive patients with lymphadenopathy.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Lymphatic Diseases, Lymphadenitis, Biopsy, Fine-Needle, Tuberculosis, Lymph Node, Biopsy, Needle, Sarcoma, Kaposi, Tuberculosis, Sensitivity and Specificity, Lymphoma, Humans, diagnosis, pathogenicity

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B10139