Diagnostic utility of fine needle aspiration (FNA) cytology in HIV-infected patients with lymphadenopathy

Sixty-five FNA cytology procedures were performed on lymph nodes in 52 HIV(+) patients. Cervical lymph nodes were the commonest site of FNA cytology investigation (54%). The diagnoses were persistent generalized lymphadenopathy (38%), infection (17%), and malignancy (11%). Diagnosis could not be rendered in 25% of FNA cytology due to inadequate sampling. Of those with infection, mycobacterial disease was the commonest cause (91%), the diagnosis of which was enhanced by concurrent microbiological examination. Non-Hodgkin's lymphoma was the commonest malignancy. Sixteen lymph node FNA cytologies had subsequent tissue biopsy. There were two false-positive and four false-negative FNA cytologies. FNA cytology in HIVS patients is most useful in the diagnosis of infection, obviating the need for tissue biopsy and allowing prompt initiation of treatment.