Patterns of enlarged cervical lymph nodes among HIV positive and negative patients in southwestern Ethiopia: a cytopathlogic analysis.

OBJECTIVE:The human immunodeficiency virus (HIV) epidemic facilitated the resurgence of extrapulmonary tuberculosis (TB) and other opportunistic diseases. This study assessed the sociodemographic and cytopathologic patterns of enlarged cervical lymph nodes among HIV positive and negative patients. MATERIALS AND METHODS:This prospective cross sectional study was conducted in Agaro Health centre, Agaro town, Oromia regional state, south western Ethiopia, for a period between April 2008 and September 2008. The instruments of the study were a structured questionnaire for data collection, fine needle aspirate cytology (FNAC) technique for the lymph nodes aspirates and blood drawn for HIV testing. The aspirates were also cultured by using Löwenstein-Jensen medium (LJ) medium. Finally, all data was cleaned, entered and analyzed by using SPSS version 13.00 statistical software and P-Value was taken significant when less than 0.05. RESULTS:A total of 82 patients were enrolled into this study. Nineteen (23.2%) patients were HIV positive. Tuberculous adenitis was the most frequent diagnosis 47/82 (57.3%). HIV positivity in patients with enlarged cervical adenopathy was 19/82 (23.2%) however, HIV and TB adenitis co-infection was 12/47 (25.5%) in the studied patients (P-Value = 0.57). TB was diagnosed cytologically in 5/11 ulcerated nodes, 11/28 purulent aspirates and 7/15 aspirates showing caseous necrosis without cellular reactions. CONCLUSIONS:About one-fourth (25.5%) of tuberculous lymph adenitis patients were co-infected with HIV. Pussy aspirates macroscopically and caseous necroses without cellularity microscopically were more common among HIV positive patients in this study. Thus, caseous necrosis with acellular reactions with or without pussy aspirates and nodal ulceration could hint immunodeficient status in co-infected individuals but this speculation need to be verified in a larger scale prospective study.