The morphological spectrum of lymphadenopathy in HIV infected patients

Wannakrairot, Pongsak; Leong, Trishe

doi:10.1080/00313020701230674

Cited by 18 publications

(10 citation statements)

References 12 publications

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“…All biopsy specimens were from the head and neck region; HIV infection was confirmed clinically and by antibody detection through ELISA with confirmation by immunofluorescent assay (IFA) or western blot. In a previous study all cases had been examined with H&E, Ziehl-Neelsen, Gram, periodic acid-Schiff (PAS), PAS with diastase, and Grocott methenamine silver stains; the morphological changes seen were divided into six inflammatory patterns: 1, classic caseating granulomas (30 cases); 2, extensive necrosis with minimal residual granulomatous response (5 cases); 3, sarcoid-like non-caseating granulomas (5 cases); 4, foamy macrophage response (5 cases); 5, inflammatory pseudotumour-like response (3 cases); and 6, non-specific lymphoid hyperplasia (7 cases) 18. The patients were not receiving anti-mycobacterial therapy at the time of biopsy.…”

Section: Methodsmentioning

confidence: 99%

Apoptosis is a major cause of so-called “caseous necrosis” in mycobacterial granulomas in HIV-infected patients

Wannakrairot

Leong

2007

J Clin Pathol

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Section: Methodsmentioning

confidence: 99%

Apoptosis is a major cause of so-called “caseous necrosis” in mycobacterial granulomas in HIV-infected patients

Wannakrairot

Leong

2007

J Clin Pathol

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“…8,9,10 Caseation alone was the most common specific and sensitive findings in most studies. Wannakrairot et al 13 not only found this to be the predominant feature in 74.5% of their cases but also found granulomas to be less numerous in AIDS than in non-AIDS patients. 13,14 Perenboom et al 15 observed that microscopic caseation was 100% predictive of tuberculosis with a sensitivity of 69%.…”

Section: Nonreactive: Areas Of Necrosis + Nuclear Debris No Epitmentioning

confidence: 99%

“…Wannakrairot et al 13 not only found this to be the predominant feature in 74.5% of their cases but also found granulomas to be less numerous in AIDS than in non-AIDS patients. 13,14 Perenboom et al 15 observed that microscopic caseation was 100% predictive of tuberculosis with a sensitivity of 69%. Most of the cases of caseating (75%) had more than 1 AFB/hpf whereas in the remaining cases (25%), number was less than 1/100hpf.…”

Section: Nonreactive: Areas Of Necrosis + Nuclear Debris No Epitmentioning

confidence: 99%

“…14 Wannakrairot et al 13 in their study noted that extensive nuclear debris was present in 10% of their cases, sometimes with scattered neutrophils and occasional eosinophils. 13 Langerhans cells were rarely present.…”

Section: Four Cases (36%) Showed Langhans Giant Cells Priyanka Chandmentioning

confidence: 99%

“…13 Langerhans cells were rarely present. The necrosis was accompanied by a minimal granulomatous response that was not distinctive and was discernible only focally.…”

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Histological Features of Tubercular Lymphadenitis in HIV Positive Patients

Agarwal¹,

Agrawal²,

Geetha³

et al. 2017

ACP

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ResultsIn the current study, 33 cases (44%) were diagnosed as tubercular lymphadenitis and were the second most common causes of lymphadenopathy after reactive hyperplasia. The presenting complaints in this group were fever (100%) followed by cough (84%) and weight loss (75%). Generalized lymphadenopathy was seen in 25 cases (75.6%) where as cervical lymphadenopathy was found in 7 cases (21.2%). One case presented with axillary lymphadenopathy. All the patients (33) were clinically diagnosed as AIDS. A raised ESR was seen in all cases ranging from 40 to 140mm/hr. The CD4 counts of all these patients ranged from 10-258/µl with the CD4 count being<200 in 84.8% of cases (Table 1) AbstractTuberculosis is one of the most common causes of lymphadenopathy in HIV positive patients. Though the presenting complaint is same as non HIV patient, the histologic features of lymph node biopsy varies depending on the immune status. The present study is conducted to find out these differences and its relevance in diagnosis. Material and methods:The histological features seen on lymph node biopsies, done on HIV positive patients who presented with lymphadenopathy, with or without other systemic manifestations over a period of three years were analysed. Seventy four lymph node biopsies were found adequate and provided the material for the present study. The lymph nodes biopsies were fixed in 10% formalin and were stained using Haematoxylin and eosin (H&E) stain. Sections were stained for AFB by using ZiehlNeelson method if H & E stained slides showed features suggestive of tuberculosis on light microscopy.Results: In the current study, 33 cases (44%) were diagnosed as tuberculous lymphadenitis and was the second most common cause of lymphadenopathy. The CD4 counts of all these patients ranged from 10-258/µl with the CD4 count being<200 in 84.8% of cases. In the present study, granulomas were detected in 90.9% of the cases and were the most common and conspicuous feature. Confluent granulomas were more commonly seen than discrete ones. Most of the cases of caseating (75%) had more than 1 AFB/hpf whereas in the remaining cases (25%), number was less than 1/100hpf. Granulomatous lymphadenitis without caseous necrosis was seen in 2 cases (6.7%). Microabscess with granular debris without coexisting granuloma was found in 11 cases (33.3%) and all showed acid fast bacilli on Ziehl-Neelsen stain. Other features noted in present study were plasmacytosis (57.6%), paracortical expansion (12.1%) and periadenitis(30.3%). In the present study, AFB was positive in all the 33 cases. Two cases were diagnosed as tuberculosis on biopsies and confirmed as atypical mycobacterium. Conclusion:Lymph node biopsy is a valuable tool in the evaluation of HIV positive patient to identify the causes of lymphadenopathy. AFB were performed in 22 cases and was strongly positive in all of them. Granulomas were detected in 90.9% of the cases and were the most common and conspicuous feature. Micro abscess with granular debris without coexisting granuloma was found i...

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Mixed Lymph Node Patterns: Including Granulomatous Lymphadenopathy, Noninfectious

Zhang

Cualing

2012

Non‐Neoplastic Hematopathology and Infections

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The morphological spectrum of lymphadenopathy in HIV infected patients

Cited by 18 publications

References 12 publications

Apoptosis is a major cause of so-called “caseous necrosis” in mycobacterial granulomas in HIV-infected patients

Apoptosis is a major cause of so-called “caseous necrosis” in mycobacterial granulomas in HIV-infected patients

Histological Features of Tubercular Lymphadenitis in HIV Positive Patients

Mixed Lymph Node Patterns: Including Granulomatous Lymphadenopathy, Noninfectious

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