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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Introduction:In Head and neck squamous cell carcinoma (HNSCC), the clinical assessment of mandibular involvement is often inaccurate and unreliable. Involvement of mandible, upstage the disease to stage IV. Investigations like orthopantogram, computed tomography (CT), magnetic resonance imaging (MRI), bone scintigraphy etc have been evaluated by different authors for involvement of mandible with wide variation in results. This has prompted us to correlate clinically, radiological, and pathological to formulate the appropriate protocol for evaluation of mandibular involvement. Methods:It is a prospective and a retrospective study. In prospective part, all patients with clinical and radiological confirmation of mandibular involvement were undergone mandibulectomy. The histologic findings of mandibular bone involvement were then compared with the radiographic findings, along with tumor location, stage, and grade. For retrospective study, the medical records of patients, who had under gone mandibulectomy as a part of treatment of oral cavity cancers were analyzed and correlated.Results: In the present study, the bone involvement was found in 69% clinically, 40.5% by Orthopantogram, 39.6% by CT scan and 54% on MRI scan. The histological confirmation of bone involvement was evaluated in all the above cases. It was found that 22% of clinically positive, 46% of OPG positive patients, 52% of CT scan positive and 46% of MRI positive had invasion Conclusion:There is no single modality of investigation which appears to have high specificity and sensitivity. Combination of different modalities increases the both sensitivity and specificity. In our study clinical examination along with high resolution CT scan has the acceptable sensitivity and specificity which may be applied for better results.

Lymphadenopathy is frequent in persons with HIV infection, occurring either as one of the earliest manifestations of infection or as a finding at any time during the course of disease. The evaluation of lymph node morphology has been one approach to diagnosis and in understanding the nature of the immune dysfunction in these conditions. To identify the various causes of lymphadenitis and evaluate the various morphologic patterns in HIV positive patients with lymphadenopathy.: Total eighty lymph node biopsies were examined. Six lymph nodes were found to be inadequate. The precise history of the patients which included ESR, fever, opportunistic infection, any other complaints, CD4+, CD8+ counts were noted. The different histological changes in the lymph nodes were evaluated. Special stain was used to detect the microorganisms. Reactive hyperplasia was the most common cause of lymphadenitis. Type B pattern was seen in most of the patients. The type of pattern correlated with the CD4 counts. Tuberculosis was the most common opportunistic infection.Lymph nodes biopsy is a valuable tool in the evaluation of HIV positive patients to identify the cause of lymphadenopathy.

Castleman's disease, also known as angiofollicular lymph node hyperplasia, is a heterogeneous group of lymphoproliferative disorders. It is a rare disease and difficult to diagnose preoperatively. Localized Castleman's disease is almost always hyaline vascular variant type. We present the case of a 30-year-old male with swelling over the left side of the neck for 10 years which was diagnosed as Castleman's disease on histopathology.