FINE-NEEDLE ASPIRATION (FNA) IN HIV- RESULTS FROM A SERIES OF 655 ASPIRATES( PATIENTS )

There are many selected small series or case reports of FNAs in patien ts with HIV infection, but large series are rare and the epidemic's ch aracteristics have evolved over time. The current study, from a large public hospital in the USA, included women as well as men, hetero- and homosexuals, in-patients and out-patients, and deep radiologically gu ided aspirates as well as superficial masses. Of 655 FNAs, reactive or benign changes were present in 37%, confirmed or suspected malignancy in 13%, specific infection with stainable organisms in 14%, and infla mmation in 16%. Twenty percent of cases were inadequate for diagnosis. Most of the identifiable infections were associated with Mycobacteriu m tuberculosis, with fewer atypical mycobacteria, fungi and other bact eria. Clinically significant diagnoses were correlated with deep aspir ate location and lesion size >2 cm, confirming other studies which als o identified tenderness and recent enlargement as important indicators . The liberal use of FNA in our HIV+ population has greatly reduced th e necessity for surgical nodal resection, reassured clinicians in cont inuing observation of reactive lymphadenopathy, and allowed immediate therapy for specific infection, cyst or malignancy.