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Chen D, Zhu Y, Chen Y, Zhu D, Liu Z, Li T, Liu Y, Zhao K, Su X, Li L. Clinical features and 18F-FDG PET/CT for distinguishing of malignant lymphoma from inflammatory lymphadenopathy in HIV-infected patients. BMC Infect Dis 2022; 22:646. [PMID: 35896979 PMCID: PMC9327211 DOI: 10.1186/s12879-022-07640-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/21/2022] [Indexed: 12/18/2022] Open
Abstract
Background It is vital to distinguish between inflammatory and malignant lymphadenopathy in human immunodeficiency virus (HIV) infected individuals. The purpose of our study was to differentiate the variations in the clinical characteristics of HIV patients, and apply 18F-FDG PET/CT parameters for distinguishing of malignant lymphoma and inflammatory lymphadenopathy in such patients. Methods This retrospective cross-sectional study included 59 consecutive HIV-infected patients who underwent whole-body 18F-FDG PET/CT. Of these patients, 37 had biopsy-proven HIV-associated lymphoma, and 22 with HIV-associated inflammatory lymphadenopathy were used as controls. The determined parameters were the maximum of standard uptake value (SUVmax), SUVmax of only lymph nodes (SUVLN), the most FDG-avid lesion-to-liver SUVmax ratio (SURmax), laboratory examinations and demographics. The optimal cut-off of 18F-FDG PET/CT value was analyzed by receiver operating characteristic curve (ROC). Results Considering the clinical records, the Karnofsky Performance Status (KPS) scores in patients with inflammatory lymphadenopathy were obviously higher than those in patients with malignant lymphoma (P = 0.015), whereas lymphocyte counts and lactate dehydrogenase (LDH) were obviously lower (P = 0.014 and 0.010, respectively). For the 18F-FDG PET/CT imaging, extra-lymphatic lesions, especially digestive tract and Waldeyer’s ring, occurred more frequently in malignant lymphoma than inflammatory lymphadenopathy. Furthermore, the SURmax and SUVLN in malignant lymphoma were markedly higher than those in inflammatory lymphadenopathy (P = 0.000 and 0.000, respectively). The cut-off point of 3.1 for SURmax had higher specificity (91.9%) and relatively reasonable sensitivity (68.2%) and the cut-off point of 8.0 for the SUVLN had high specificity (89.2%) and relatively reasonable sensitivity (63.6%). Conclusion Our study identified the distinctive characteristics of the clinical manifestations, the SURmax, SUVLN and detectability of extra-lymphatic lesions on 18F-FDG PET, and thus provides a new basis for distinguishing of malignant lymphoma from inflammatory lymphadenopathy in HIV-infected patients.
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Affiliation(s)
- Donghe Chen
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Yunqi Zhu
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Yunbo Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Danhua Zhu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Zhengfeng Liu
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Tiancheng Li
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Yinuo Liu
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Kui Zhao
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
| | - Xinhui Su
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
| | - Lanjuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
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Goodman MD. Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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3
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Spectrum of [ 18F]FDG-PET/CT Findings in Benign Lymph Node Pathology. Mol Imaging Biol 2021; 23:469-480. [PMID: 33512649 PMCID: PMC8277624 DOI: 10.1007/s11307-020-01576-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 01/18/2023]
Abstract
Diffuse lymphadenopathy has a long differential diagnosis that includes both malignant and benign causes. As part of the lymphadenopathy work-up, many patients undergo [18F]FDG-PET/CT for purposes of ruling out malignancy. FDG-avid lymph nodes, however, are not specific for malignancy. This review will illustrate the spectrum of nodal findings on FDG-PET/CT with correlation to other cross-sectional imaging and clinical history in patients with representative infectious, inflammatory, and benign lymphoproliferative disorders. These findings are important for the nuclear medicine radiologist to understand, as they can represent common pitfalls in the work-up of lymphadenopathy. While FDG-PET/CT may be limited in ascertaining a definitive diagnosis in a disease process as the cause of lymphadenopathy, it can help to narrow this differential and rule out certain diseases in the correct clinical context.
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4
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Abstract
OBJECTIVE. The purpose of this article is to review important imaging and clinical features to help elucidate causes of lymphadenopathy in patients with HIV infection. CONCLUSION. HIV lymphadenopathy has various causes generally categorized as inflammatory or reactive, such as immune reconstitution syndrome; infectious, such as tuberculous and nontuberculous mycobacterial infections and HIV infection itself; and neoplastic, such as lymphoma, Kaposi sarcoma, and Castleman disease. It is important to consider patients' demographic characteristics, clinical presentations, CD4 lymphocyte counts, and radiologic features to identify likely causes of lymphadenopathy.
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5
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Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome. Fam Med 2020. [DOI: 10.1007/978-1-4939-0779-3_44-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Šimeková K, Nováková E, Rosoľanka R, Masná J, Antolová D. Clinical Course of Opportunistic Infections-Toxoplasmosis and Cytomegalovirus Infection in HIV-Infected Patients in Slovakia. Pathogens 2019; 8:pathogens8040219. [PMID: 31690039 PMCID: PMC6963677 DOI: 10.3390/pathogens8040219] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/28/2019] [Accepted: 10/30/2019] [Indexed: 11/16/2022] Open
Abstract
: The HIV/acquired immunodeficiency syndrome (AIDS) pandemic has affected the health status of the population in many countries. Early symptomatic HIV infection includes persistent generalized lymphadenopathy (PGL), which can be associated with opportunistic infections, e.g., toxoplasmosis and Cytomegalovirus (CMV) infection. This study followed the occurrence of PGL, toxoplasmosis, and Cytomegalovirus infection in 32 HIV-positive patients and analyzed the clinical signs of disease in relation to the number of CD4 T lymphocytes. In monitored patients, the average number of CD4 T lymphocytes was 940.8 ± 396.7/µL of blood. Severe immunodeficiency was recorded in four persons, who also suffered from colitis and/or retinitis and pneumonitis. The number of CD4 T cells in patients with PGL was significantly lower than that in patients without lymphadenopathy. In 6 (18.8%) IgM and 11 (34.4%) IgG Toxoplasma gondii seropositive patients, the number of CD4 T lymphocytes was significantly lower than that in seronegative patients. The presence of IgM and IgG antibodies to Cytomegalovirus was recorded in all examined patients, and CMV infection clinically manifested in five persons. The occurrence of PGL, the higher viral load, and seropositivity to T. gondii were significantly related to decline in the CD4 T lymphocyte number. The clinical course of the diseases was influenced by the status of the patient's immunodeficiency and suggests ongoing immunosuppression and possible reactivation of both infections in all patients.
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Affiliation(s)
- Katarína Šimeková
- Clinic of Infectology and Travel Medicine, Comenius University Bratislava, Jessenius Faculty of Medicine and University Hospital in Martin, Kollárova 2, 036 01 Martin, Slovakia.
| | - Elena Nováková
- Institute of Microbiology and Immunology, Comenius University Bratislava, Jessenius Faculty of Medicine and University Hospital in Martin, Kollárova 2, 036 01 Martin, Slovakia.
| | - Róbert Rosoľanka
- Clinic of Infectology and Travel Medicine, Comenius University Bratislava, Jessenius Faculty of Medicine and University Hospital in Martin, Kollárova 2, 036 01 Martin, Slovakia.
| | - Jana Masná
- Clinic of Infectology and Travel Medicine, Comenius University Bratislava, Jessenius Faculty of Medicine and University Hospital in Martin, Kollárova 2, 036 01 Martin, Slovakia.
| | - Daniela Antolová
- Institute of Parasitology of Slovak Academy of Sciences, Hlinkova 3, 040 01 Košice, Slovakia.
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Tomoka T, Painschab MS, Montgomery ND, Seguin R, Mulenga M, Kaimila B, Kasonkanji E, Zuze T, Nyasosela R, Nyirenda R, Chikasema M, Tewete B, Mtangwanika A, Chiyoyola S, Chimzimu F, Kampani C, Fedoriw Y, Gopal S. A prospective description of HIV-associated multicentric Castleman disease in Malawi. Haematologica 2018; 104:e215-e217. [PMID: 30442726 DOI: 10.3324/haematol.2018.204479] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Tamiwe Tomoka
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC, USA .,Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi.,Department of Pathology, University of Malawi College of Medicine, Blantyre, Malawi
| | - Matthew S Painschab
- Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi.,Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Nathan D Montgomery
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC, USA.,Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi
| | - Ryan Seguin
- Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi
| | - Maurice Mulenga
- Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi
| | - Bongani Kaimila
- Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi
| | - Edwards Kasonkanji
- Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi
| | - Takondwa Zuze
- Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi
| | - Richard Nyasosela
- Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi
| | - Ruth Nyirenda
- Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi
| | - Maria Chikasema
- Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi
| | - Blessings Tewete
- Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi
| | | | - Sarah Chiyoyola
- Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi
| | - Fred Chimzimu
- Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi
| | - Coxcilly Kampani
- Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi
| | - Yuri Fedoriw
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC, USA.,Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi
| | - Satish Gopal
- Malawi Cancer Consortium and Regional Center of Research Excellence for NCDs, Lilongwe, Malawi.,Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.,Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.,Department of Medicine, University of Malawi College of Medicine, Blantyre, Malawi
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Abstract
This article describes the various non-neoplastic lymphadenopathies that occur in patients infected with the human immunodeficiency virus (HIV), before or during the stage of acquired immunodeficiency syndrome (AIDS). The stages that develop during the HIV infection include: primary infection (acute infection, spread of the virus, development of host immune response, and acute retroviral syndrome), chronic infection or clinical latency, and finally, the AIDS stage. Non-neoplastic lymphadenopathies can occur at any of these phases of the infection and are due to multiple causes that can be divided into infectious causes (bacterial, fungal, parasitic, viral), and reactive causes (persistent generalized lymphadenopathy and a variety of situations that they also occur in immunocompetent people such as Castleman's disease and Kikuchi-Fujimoto's disease, among others). The general, histological and immunophenotypic characteristics of these pathologies are described.
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Affiliation(s)
- Carlos Barrionuevo-Cornejo
- Department of Pathology, Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima 34, Peru.
| | - Daniela Dueñas-Hancco
- Department of Pathology, Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima 34, Peru
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Neves B, Raimundo P, Farinha P. Fever and generalised lymphadenopathy in an HIV-positive patient: a diagnostic challenge. BMJ Case Rep 2017; 2017:bcr-2017-220740. [PMID: 28814592 DOI: 10.1136/bcr-2017-220740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Fever and generalised lymphadenopathy is a common presentation of a variety of diseases and a thorough investigation is often necessary for appropriate diagnosis.We present a 53-year-old male patient admitted with fever, weight loss of 15 kg in 3 months and abdominal discomfort. Examination was only remarkable for axillary and inguinal lymphadenopathy. Blood tests showed normocytic normochromic anaemia, cholestasis and a previously unknown HIV-1 infection with lymphocyte CD4 +count of 239 cells/mm3 and viral load 3.172.370 copies/mL. A body CT scan showed multiple axillary, mediastinal, lumbar, aortic, iliac and pelvic lymphadenopathy as well as hepatosplenomegaly. An excisional biopsy of the left axillary lymphadenopathy was performed and histology ultimately revealed multicentric Castleman's disease associated with Human Herpes Virus-8. After initiation of antiretroviral therapy, rituximab was given and progressive clinical improvement occurred.
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Affiliation(s)
- Bernardo Neves
- Internal Medicine, Hospital da Luz, Lisboa, Lisboa, Portugal
| | - Pedro Raimundo
- Internal Medicine, Hospital da Luz, Lisboa, Lisboa, Portugal
| | - Pedro Farinha
- Pathology Anatomy, Centro Hospitalar de Lisboa Central EPE, Lisboa, Lisboa, Portugal
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10
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Yu HT, Lee CH, Huang SC, Yu SF. Unsuspected human immunodeficiency virus infection presenting as immunoglobulin G4-related lymphadenopathy: a case report. Int J STD AIDS 2017; 29:92-95. [PMID: 28768471 DOI: 10.1177/0956462417722479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is an immune-mediated condition characterized by infiltration of the involved organs by IgG4-bearing plasma cells. The prevalence of autoimmune diseases, associated with or occurring in patients with human immunodeficiency virus (HIV) infection, has been increasing. We describe a 58-year-old man with an undiagnosed HIV infection, which presented as chronic cervical lymphadenopathy with an elevated serum IgG4 and a very high IgE. Histologically, lymph nodes showed expanded sinusoids and burnt-out germinal centers with increased plasmacytic infiltration and collagen fiber deposition. The absolute number of IgG4+ plasma cells and the IgG4+/IgG+ plasma cell ratio was increased. The lymph nodes were enlarged and clinically the patient improved after steroid treatment. Nine months later, he was diagnosed with acquired immune deficiency syndrome, following presentation with a cavitary left lung lesion. Immunohistochemical studies on the previously resected lymph node revealed complete absence of CD4+ T-lymphocytes and increased CD8+ T-lymphocytes. The pathologic findings met the criteria of both HIV infection and IgG4-related lymphadenopathy. Our case demonstrates that further investigations for underlying HIV infection in a case of IgG4-RD are critical, especially when extremely elevated IgE is concomitantly present.
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Affiliation(s)
- Hsing-Tse Yu
- 1 Department of Obstetrics and Gynecology, 117544 Linkou Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Chen-Hsiang Lee
- 2 Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shun-Chen Huang
- 3 Department of Anatomic Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shan-Fu Yu
- 4 Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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11
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[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.
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Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome. Fam Med 2017. [DOI: 10.1007/978-3-319-04414-9_44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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EXP CLIN TRANSPLANTExp Clin Transplant 2015; 13. [DOI: 10.6002/ect.mesot2014.o153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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14
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Unusual initial presentation of herpes simplex virus as inguinal lymphadenopathy. Case Rep Pathol 2015; 2015:573230. [PMID: 25815228 PMCID: PMC4357043 DOI: 10.1155/2015/573230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 02/17/2015] [Indexed: 11/19/2022] Open
Abstract
Genital herpes simplex virus (HSV) infections are a common cause of inguinal lymphadenopathy. However, surgical excision of enlarged inguinal nodes is almost never performed to initially diagnose genital herpes simplex virus, due to the distinct external presentation of genital herpetic vesicles that usually occur with the first symptoms of infection. Therefore, the histologic and immunophenotypic features of HSV-associated inguinal lymphadenopathy are unfamiliar to most pathologists. The current report describes the lymph node pathology of two immunocompetent patients, whose initial HSV diagnosis was established through surgical excision of enlarged inguinal lymph nodes. Histologic examination showed features consistent with viral lymphadenopathy, including florid follicular hyperplasia, monocytoid B-cell hyperplasia, and paracortical hyperplasia without extensive necrosis. Immunohistochemical stains for HSV antigens, using polyclonal anti-HSV I and II antibodies, demonstrate strong immunoreactivity for HSV in a small number of cells in the subcapsular sinuses, especially in areas with monocytoid B-cell hyperplasia. Rare scattered HSV-positive cells also are identified in paracortical areas and germinal centers. We conclude that an initial diagnosis of genital HSV infection may be established by inguinal lymph node biopsy.
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Goodman MD. Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome. Fam Med 2015. [DOI: 10.1007/978-1-4939-0779-3_44-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gandhi RT, Alkasab TK, Nardi V, Branda JA. Case records of the Massachusetts General Hospital. Case 40-2014. A 57-year-old man with inguinal pain, lymphadenopathy, and HIV infection. N Engl J Med 2014; 371:2511-20. [PMID: 25539108 DOI: 10.1056/nejmcpc1404518] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Hadadi A, Jafari S, Jebeli ZH, Hamidian R. Frequncy and etiology of lymphadenopathy in Iranian HIV/AIDS patients. Asian Pac J Trop Biomed 2014; 4:S171-6. [PMID: 25183076 DOI: 10.12980/apjtb.4.2014c1253] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 03/02/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To estimate and outline the frequency and etiology of lymphadenopathy in HIV/AIDS patients. METHODS This study was conducted on 178 consecutive HIV/AIDS patient files for etiologies (categorized into three sub-groups: definite, probable and possible) and associated factors of local and generalized lymphadenopathy. RESULTS Seventy-two (40.45%) patients including 63 male patients (87.5%) developed lymphadenopathy. HIV in lymphadenopathy(+) patients was most commonly transmitted intravenously (n=49). Generalized and localized lymphadenopathy respectively occurred in 27 (37.50%) and 45 (62.50%) patients, mainly in the cervical region (28.9% for local and 63% for generalized lymphadenopathy). The most common causes of lymphadenopathy were tuberculosis (n=24, 33.3%) and lymphoma (n=12, 16.6%). The frequency of lymphadenopathy was non-significantly higher in patients with AIDS (CD4 count <200 cell/µL) vs. HIV(+) patients (CD4 count >200 cell/µL). CONCLUSIONS Lymphadenopathy in HIV/AIDS patients may reflect a serious condition, most likely tuberculosis and lymphoma. Since patients might underestimate lymphadenopathy, physicians would rather list these entities for diagnosis.
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Affiliation(s)
- Azar Hadadi
- Iranian Research Center for HIV/AIDS Institute of High Risk Behavior Reduction, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran ; Internal Medicine Department & Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sirous Jafari
- Infectious Diseases Department and Iranian Research Center for HIV/AIDS, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Reza Hamidian
- Research Development Center, Sina hospital, Tehran University of Medical Sciences, Tehran, Iran
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