1
|
Perricone AJ, Mohammad MK, Geller RL, Mosunjac MB. Cytodiagnostic Sensitivity of Fine Needle Aspiration Biopsy for Hodgkin's Lymphoma Is Decreased in Patients with Human Immunodeficiency Virus Infection. Acta Cytol 2019; 63:352-360. [PMID: 31234174 DOI: 10.1159/000501098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 05/20/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE We aimed to evaluate the sensitivity of fine needle aspiration (FNA) for the diagnosis of Hodgkin's lymphoma (HL) in HIV-infected patients. STUDY DESIGN An electronic search was conducted to retrospectively identify patients diagnosed with HL who underwent FNA followed by confirmatory biopsy. FNAs were categorized as negative, atypical/suspicious/positive, or nondiagnostic. Diagnostic sensitivity in HIV+ and HIV- patients was statistically compared via Fisher's exact test, with a p value <0.05 considered significant. RESULTS Thirty-six patients meeting inclusion criteria were identified (24 HIV- and 12 HIV+). Average age was 36.0 ± 11.5 and 36.5 ± 7.4 years (means ± SD) in HIV- and HIV+ patients, respectively. The male-to-female ratio was 1.4:1 in HIV- patients versus 3:1 in HIV+ patients. Among these 36 patients, a total of 42 FNAs were performed. Overall sensitivity of FNA was 66.7% (95% confidence interval: 52.4-80.9%). When stratified by HIV status, a statistically significant difference in FNA sensitivity was detected, as sen-sitivity was 84.6% (70.8-98.4%) in HIV- patients versus only 37.5% (13.8-61.2%) in HIV+ patients (p =0.003). CONCLUSION The diagnostic sensitivity of FNA biopsy was significantly attenuated in the HIV+ cohort. In HIV-infected patients presenting with lymphadenopathy, increased clinical suspicion of HL is critical to avoid misdiagnosis.
Collapse
Affiliation(s)
- Adam J Perricone
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA
- Department of Pathology and Laboratory Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA
| | - Mohammad K Mohammad
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA
- Department of Pathology and Laboratory Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA
| | - Rachel L Geller
- Fulton County Medical Examiner's Office, Atlanta, Georgia, USA
| | - Marina B Mosunjac
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA,
- Department of Pathology and Laboratory Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA,
| |
Collapse
|
2
|
Suresh PK, Poojary S, Basavaiah SH, Kini JR, Lobo FD, Sahu KK. Utility of fine-needle aspiration cytology in the diagnosis of HIV lymphadenopathy. Diagn Cytopathol 2019; 47:1011-1017. [PMID: 31207176 DOI: 10.1002/dc.24255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/20/2019] [Accepted: 05/31/2019] [Indexed: 11/08/2022]
Abstract
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.
Collapse
Affiliation(s)
- Pooja K Suresh
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shweta Poojary
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.,Department of Radiodiagnosis, Junior Resident, Bangalore Medical College and Research Centre, Bangalore, Karnataka, India
| | - Sridevi Hanganahalli Basavaiah
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Jyoti R Kini
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Flora D Lobo
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Kausalya K Sahu
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| |
Collapse
|
3
|
Carrilho C, Ismail M, Lorenzoni C, Fernandes F, Alberto M, Akrami K, Funzamo C, Lunet N, Schmitt F. Fine needle aspiration cytology in Mozambique: Report of a 15-year experience. Diagn Cytopathol 2018; 47:166-171. [PMID: 30478961 DOI: 10.1002/dc.24062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/25/2018] [Accepted: 08/03/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Fine needle aspiration cytology (FNAC) is an important diagnostic tool in a range of medical settings. It is fast, quick and a highly accurate diagnostic method and can be used, in settings with minimal laboratory infrastructures. METHODS In this report, we describe the experience in the use of FNAC since it is introduction in 1996 in the Anatomical Pathology Service of the Maputo Central Hospital (MCH), along with more detailed data referring to 2009-2010. RESULTS The number of FNAC analyses increased gradually from 269 (4.1% of all pathologic tests of the Service) in 1996, when it was introduced in Mozambique, to 3234 (17% of all tests) in 2010. Lymph nodes were the organs most frequently biopsied, followed by breast and soft tissues. Inflammatory conditions, especially tuberculosis, were the most frequent diagnoses (22.2% of the cases), followed by hyperplastic conditions (20.6%), benign tumors (13.4%) and malignant tumors (12.3%). CONCLUSION Our results clearly demonstrate that even in an environment with poor laboratory resources, it is possible to establish a FNAC clinic that can provide a quick and precise diagnosis for clinicians to aid in early treatment interventions, especially in inflammatory diseases which were the majority of our cases.
Collapse
Affiliation(s)
- Carla Carrilho
- Departamento de Patologia, Hospital Central de Maputo, Maputo, Moçambique.,Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Moçambique
| | - Mamudo Ismail
- Departamento de Patologia, Hospital Central de Maputo, Maputo, Moçambique.,Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Moçambique
| | - Cesaltina Lorenzoni
- Departamento de Patologia, Hospital Central de Maputo, Maputo, Moçambique.,Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Moçambique.,National Cancer Control Program Ministry of Health, Maputo, Mozambique
| | - Fabíola Fernandes
- Departamento de Patologia, Hospital Central de Maputo, Maputo, Moçambique.,Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Moçambique
| | - Matos Alberto
- Departamento de Patologia, Hospital Central de Maputo, Maputo, Moçambique
| | - Kevan Akrami
- Department of Infectious Disease, University of California, San Diego, San Diego, California
| | - Carlos Funzamo
- National Cancer Control Program Ministry of Health, Maputo, Mozambique
| | - Nuno Lunet
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Fernando Schmitt
- Instituto de Patologia e Imunologia Molecular da Universidade do Porto, IPATIMUP, Porto, Portugal.,Departamento de Patologia da Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| |
Collapse
|
4
|
Gupta A, Ghosh A, Singh G, Xess I. A Twenty-First-Century Perspective of Disseminated Histoplasmosis in India: Literature Review and Retrospective Analysis of Published and Unpublished Cases at a Tertiary Care Hospital in North India. Mycopathologia 2017; 182:1077-1093. [PMID: 29080114 DOI: 10.1007/s11046-017-0191-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 08/08/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE Published literature lacks systematic studies on disseminated histoplasmosis in India, and previous reviews on its epidemiology in India were conducted two decades back. Thus, we review the Indian studies published in this century to understand the recent epidemiology of histoplasmosis in India and do a retrospective analysis of all cases diagnosed at our institute. METHODS A literature of review search was done in Pubmed/Medline and Scopus. Studies published during January 2001-December 2015 were considered along with retrospective analysis of cases presented to us. A distinction was made in the clinical presentation of immunocompetent and immunocompromised cases. RESULTS Ninety-five included studies described 204 cases, and 10 cases from our retrospective analysis were included. The mean age at presentation was 45.1 ± 15.4 years [range 3-83, median 45, interquartile range 37-55], and male-to-female ratio was 6:1. Most cases were reported from northern and northeastern states of India along the rivers Ganges, Yamuna and Brahmaputra and in people associated with agricultural activity. About 33% of cases were immunocompromised, out of which immunosuppression due to HIV was seen in 72% cases. The mean age of presentation was significantly lower in immunocompromised cases (37.9 vs. 49.2 years; p < 0.00001, Mann-Whitney test), and mortality was also higher (10 vs. 27.5%, p = 0.01, Fisher's exact test). Adrenal involvement was in significantly higher proportion of immunocompetent patients compared to immunocompromised population. CONCLUSIONS Disseminated histoplasmosis is being increasingly recognized in India. There is a need to undertake well-designed, analytical studies utilizing appropriate diagnostic modalities to understand the epidemiology of this neglected disease in proper perspective.
Collapse
Affiliation(s)
- Ayush Gupta
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Arnab Ghosh
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Gagandeep Singh
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Immaculata Xess
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
| |
Collapse
|
5
|
[Pathological findings in patients with HIV infection and lymphadenopathies]. BIOMEDICA 2017; 37:79-85. [PMID: 28527251 DOI: 10.7705/biomedica.v37i1.3293] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/31/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Lymphadenopathy is a frequent clinical finding in HIV-infected patients. The differential diagnosis includes infection, malignancy or reactive changes. Currently, there are no data on this topic in the region. OBJECTIVES To describe the etiology of lymph node pathology in HIV-infected patients from the Hospital La María in Medellín, Colombia. MATERIALS AND METHODS The medical records of HIV-infected patients with lymphadenopathy who underwent excisional lymph node biopsy between June 2009 and October 2011 were retrospectively evaluated. The data were registered according to immune status, antiretroviral therapy and final diagnosis. RESULTS The evaluation of 120 medical records revealed the following diagnosis distribution: 58% of the cases were attributable to infectious causes, 32.5% were attributable to reactive changes, 6.6% were attributable to neoplastic disease, and 2.5% were normal. The most frequent diagnosis was tuberculosis, which was found in 48.3% of the patients. The lymph node biopsy was useful for identifying additional opportunistic infections in different organs in 14.1% of the patients. CONCLUSION A lymph node biopsy in HIV-infected patients is a useful aid in the diagnosis of serious neoplastic and infectious diseases and should be routinely performed in such patients with lymphadenopathy.
Collapse
|
6
|
Viegas SO, Ghebremichael S, Massawo L, Alberto M, Fernandes FC, Monteiro E, Couvin D, Matavele JM, Rastogi N, Correia-Neves M, Machado A, Carrilho C, Groenheit R, Källenius G, Koivula T. Mycobacterium tuberculosis causing tuberculous lymphadenitis in Maputo, Mozambique. BMC Microbiol 2015; 15:268. [PMID: 26589993 PMCID: PMC4654834 DOI: 10.1186/s12866-015-0603-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 11/12/2015] [Indexed: 01/29/2023] Open
Abstract
Background 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. Results 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. Conclusions 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. Electronic supplementary material The online version of this article (doi:10.1186/s12866-015-0603-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Sofia Omar Viegas
- National Institute of Health, Ministry of Health, Maputo, Mozambique. .,Faculty of Veterinary, Eduardo Mondlane University, Maputo, Mozambique. .,Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
| | | | - Leguesse Massawo
- National Institute of Health, Ministry of Health, Maputo, Mozambique.
| | - Matos Alberto
- Pathology Service, Maputo Central Hospital, Ministry of Health, Maputo, Mozambique.
| | - Fabíola Couto Fernandes
- Pathology Service, Maputo Central Hospital, Ministry of Health, Maputo, Mozambique. .,Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
| | - Eliane Monteiro
- Pathology Service, Maputo Central Hospital, Ministry of Health, Maputo, Mozambique.
| | - David Couvin
- WHO Supranational TB Reference Laboratory, Tuberculosis & Mycobacteria Unit, Institut Pasteur de la Guadeloupe, Abymes, Guadeloupe, France.
| | | | - Nalin Rastogi
- WHO Supranational TB Reference Laboratory, Tuberculosis & Mycobacteria Unit, Institut Pasteur de la Guadeloupe, Abymes, Guadeloupe, France.
| | - Margarida Correia-Neves
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden. .,Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal. .,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.
| | - Adelina Machado
- Faculty of Veterinary, Eduardo Mondlane University, Maputo, Mozambique.
| | - Carla Carrilho
- Pathology Service, Maputo Central Hospital, Ministry of Health, Maputo, Mozambique. .,Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
| | - Ramona Groenheit
- Department of Microbiology, Public Health Agency of Sweden, Solna, Sweden.
| | - Gunilla Källenius
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
| | - Tuija Koivula
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden. .,Department of Microbiology, Public Health Agency of Sweden, Solna, Sweden.
| |
Collapse
|
7
|
Mandal R, Mondal K, Datta S, Chakrabarti I, Giri A, Goswami BK. A clinicopathological study of peripheral lymph nodes in HIV-infected patients with special reference to CD4+ T-cell counts: Experience from a tertiary care institution in Darjeeling (India). Diagn Cytopathol 2015; 43:971-7. [PMID: 26457991 DOI: 10.1002/dc.23379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 08/13/2015] [Accepted: 09/24/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND HIV/AIDS is a major health burden worldwide. India bears the third highest HIV-patients load globally. In the Darjeeling district, HIV-prevalence is >1% with very little known about the profile of HIV-lymphadenopathy. The aim of this study was to identify the different causes of peripheral lymphadenopathy among HIV-infected patients in this region, correlate them with CD4+ T-cell counts and formulate some common clinico-haematological parameters as potential predictors of CD4+ T-cell count. METHODS In the present study, 76 cases were evaluated. Fine Needle Aspiration Cytology (FNAC) was performed as an out-patient procedure in the Department of Pathology. Smears were stained routinely with Haematoxylin-Eosin and Leishman stains. ZN stains were done when indicated by the cytological findings. Immediate CD4+ T-cell count was obtained by referring the patients to the Anti-retroviral therapy centre. RESULTS Cytological diagnoses included tuberculosis (82.9%), reactive hyperplasia (6.6%), nonspecific granulomatous lesions (3.9%), non-Hodgkin lymphoma (2.6%), histoplasmosis (2.6%) and simultaneous filariasis with toxoplasmosis (1.3%). Statistically, the opportunistic infections and lymphomas significantly concurred with a CD4+ T-cell count <350/μl. Likewise, the number of enlarged lymph nodes and absolute lymphocyte count (ALC) were found to be useful predictors of CD4+ T-cell counts. CONCLUSIONS Lymph node cytology in HIV-infected patients is essential to identify opportunistic infections from neoplastic lesions and; to enable therapeutic strategies. Correlation of lesions with mean CD4+ T-cell count predicts personal immunity, stage of disease and disease activity. Furthermore, enlarged lymph node numbers and ALC can be surrogate markers of CD4+ T-cell count for monitoring the severity of the immune suppression in under-resourced countries like India.
Collapse
Affiliation(s)
- Rupali Mandal
- Department of Pathology, North Bengal Medical College & Hospital, India
| | - Krishnendu Mondal
- Department of Pathology, North Bengal Medical College & Hospital, India
| | - Saikat Datta
- Department of General Medicine, North Bengal Medical College & Hospital, India
| | | | - Amita Giri
- Department of Pathology, North Bengal Medical College & Hospital, India
| | | |
Collapse
|
8
|
Nieuwoudt M, Lameris R, Corcoran C, Rossouw TM, Slavik T, Du Plessis J, Omoshoro-Jones JAO, Stivaktas P, Potgieter F, Van der Merwe SW. Polymerase chain reaction amplifying mycobacterial DNA from aspirates obtained by endoscopic ultrasound allows accurate diagnosis of mycobacterial disease in HIV-positive patients with abdominal lymphadenopathy. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:2031-2038. [PMID: 25023118 DOI: 10.1016/j.ultrasmedbio.2014.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 04/01/2014] [Accepted: 04/04/2014] [Indexed: 06/03/2023]
Abstract
Abdominal lymphadenopathy in human immunodeficiency virus (HIV) infection remains a diagnostic challenge. We performed a prospective cohort study by recruiting 31 symptomatic HIV + patients with abdominal lymphadenopathy and assessing the diagnostic yield of endoscopic ultrasound fine-needle aspiration (EUS-FNA). Mean age was 38 years; 52% were female; and mean CD4 count and viral load were 124 cells/μL and 4 log, respectively. EUS confirmed additional mediastinal nodes in 26%. The porta hepatis was the most common abdominal site. Aspirates obtained by EUS-FNA were subjected to cytology, culture and polymerase chain reaction (PCR) analysis. Mycobacterial infections were confirmed in 67.7%, and 31% had reactive lymphadenopathy. Cytology and culture had low sensitivity, whereas PCR identified 90% of mycobacterial infections. By combining the appearance of aspirates obtained by EUS-FNA and cytologic specimens, we developed a diagnostic algorithm to indicate when analysis with PCR would be useful. PCR performed on material obtained by EUS-FNA was highly accurate in confirming mycobacterial disease and determining genotypic drug resistance.
Collapse
Affiliation(s)
- Martin Nieuwoudt
- Hepatology and GI Research Laboratory, Department of Immunology, University of Pretoria, Pretoria, South Africa; DST/NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
| | - Roeland Lameris
- Hepatology and GI Research Laboratory, Department of Immunology, University of Pretoria, Pretoria, South Africa
| | - Craig Corcoran
- Department of Molecular Pathology, Ampath Laboratories, Pretoria, South Africa
| | - Theresa M Rossouw
- Department of Family Medicine, University of Pretoria, Pretoria, South Africa
| | - Tomas Slavik
- Department of Pathology, Ampath laboratories, Pretoria, South Africa; Department of Anatomical Pathology, University of Pretoria, Pretoria, South Africa
| | - Johannie Du Plessis
- Hepatology and GI Research Laboratory, Department of Immunology, University of Pretoria, Pretoria, South Africa
| | - Jones A O Omoshoro-Jones
- Department of Surgery, Chris Hani-Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - Paraskevi Stivaktas
- MRC Unit of Inflammation and Immunity, Department of Immunology, University of Pretoria, Pretoria, South Africa; Tshwane Academic Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Fritz Potgieter
- Interventional GI Unit, Pretoria East Hospital, Pretoria, South Africa
| | - Schalk W Van der Merwe
- Hepatology and GI Research Laboratory, Department of Immunology, University of Pretoria, Pretoria, South Africa.
| |
Collapse
|
9
|
Dogbey P, Golden M, Ngo N. Cryptococcal lymphadenitis: an unusual initial presentation of HIV infection. BMJ Case Rep 2013; 2013:bcr-2013-010316. [PMID: 24014328 DOI: 10.1136/bcr-2013-010316] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Lymphadenopathy can occur at any stage of HIV infection, with multiple aetiologies including reactive, infectious and malignant. An accurate and timely diagnosis has obvious implications for treatment. We report cryptococcal lymphadenitis as the presenting manifestation of HIV infection. The diagnosis in our patient was eventually confirmed with a lymph node biopsy. Fine needle aspiration cytology has been shown to be a rapid and cost-effective method, which has been used in the diagnosis of lymphadenopathy in HIV infection, and could have been used to make an earlier diagnosis in our patient.
Collapse
Affiliation(s)
- Pia Dogbey
- Department of Internal Medicine, Yale New Haven Hospital, Saint Raphael Campus, New Haven, Connecticut, USA
| | | | | |
Collapse
|
10
|
Kuttiatt V, Sreenivasa P, Garg I, Shet A. Cryptococcal lymphadenitis and immune reconstitution inflammatory syndrome: Current considerations. ACTA ACUST UNITED AC 2011; 43:664-8. [DOI: 10.3109/00365548.2011.574293] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|