The Diagnostic Results of Cervical Lymph Node FNAB Compared to Conventional Biopsy in HIV/AIDS Patients with TB Lymphadenopathy in the Bamrasnaradura Institute
Keywords:
Lymphadenopathy, FNA, FNAB, HIV, AIDSAbstract
Background: Cervical lymphadenopathy is a common clinical presentation in HIV/AIDS patients at Bamrasnaradura Institute. Conventional lymph node biopsy is the standard procedure for the diagnosis of this condition but the procedure incurs a high risk for healthcare providers.
Objective: To compare the diagnostic results of two procedures, Fine Needle Aspiration Biopsy (FNAB) and conventional cervical Iymph node biopsy, in HIV/AIDS patients with cervical lymphadenopathy.
Materials and Methods: This study is a prospective comparison of an alternative procedure for the diagnosis of mycobacterial infection, Fine Needle Aspiration Biopsy (FNAB), with the conventional method. The study population comprises HIV/AIDS patients who attended the surgical clinic at Bamrasnaradura Institute.
Results: The most common pathology found in HIV/AIDS patients with cervical lymphadenopathy was TB lymphadenopathy, followed by fungus infection. AFB staining from FNAB, compared to the conventional biopsy, gave the same results. The cytological results from FNAB gave a low sensitivity (31.71%) and a high specificity (100%) when compared to the pathological study with the conventional biopsy (gold standard). The combination of AFB staining and cytological results increased the sensitivity of FNAB to 58.53%. The AFB stain from FNAB alone gave a sensitivity of 56.10%.
Conclusion: The results of the study recommend the use of FNAB at the Institute, because it is practical, convenient and less risky than the conventional method. Due to the high prevalence of mycobacterial infection in HIV/AIDS patients in the Institute, a positive result from FNAB can confidentially determine treatment for TB, but clinicians should be aware of the low sensitivity of FNAB when compared to conventional biopsy, and the possibility of "false negative" results.
References
2. Lau SK, et al. FNA Biopsy of tuberculous cervical lymphadenopathy. Aust NZ J Surg 1988; 58: 947-50.
3. Nada A, et al. Fine needle aspiration cytology versus histopathology in Diagnosing Lymph Node Lesions. Indian J Med Res 1996;2:320-5.
4. Frable WJ. Thin needle aspiration biopsy. Am J Clin Pathol 1976;65:168-80.
5. Koss LG. Diagnostic cytology and its histopathologic bases. Philadelphia: JB Lippincott Co; 1979.
6. Martelli G, et al. Fine needle aspiration cytology in superficial lymph nodes. Eur J Surg Oncol 1989; 15: 13-6.
7. Stani J. Cytologic diagnosis of reactive lymphadenopathy in fine needle aspiration biopsy specimens. Acta Cytologica 1987;31:8-13.
8. Supraporn S, et al. Diagnostic terminology of breast fine needle aspiration (FNA) cytology, Breast cancer, Bangkok: Primdee; 2542. p. 89-104.
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