Importance of human immunodeficiency virus-associated lymphadenopathy and tuberculous lymphadenitis in patients undergoing lymph node biopsy in Zambia

Abstract

The relative importance of human immunodeficiency virus (HIV)-associated lymphadenopathy amongst patients presenting for lymph node biopsy in Central Africa is unknown. HIV-1 serology and histology of patients undergoing superficial lymph node biopsy during 1989-1990 in Lusaka, Zambia, were examined in a prospective cohort study of HIV serology and by retrospective review of laboratory records. Of 727 lymph nodes biopsied in Lusaka in 1989-1990, 380 (52 per cent) showed tuberculous lymphadenitis, 160 (22 per cent) histology suggestive of primary HIV lymphadenopathy and 66 (9 per cent) nodal Kaposi's disease. HIV serology was tested in 280 adults and was positive in 91 per cent (255 patients), including 89 per cent (153 of 171) of those with tuberculous lymphadenitis, 98 per cent (63 of 64) of those with histology suspicious of primary HIV lymphadenopathy and all (24 of 24) with nodal Kaposi's disease. Other HIV-associated lymphadenopathy included nodal lymphomas and lymphoepithelial cysts. HIV serology was tested in 22 children and was positive in eight, including four of 14 with tuberculous lymphadenitis. It is concluded that HIV-associated lymphadenopathy, especially tuberculous lymphadenitis, is very common amongst patients presenting for lymph node biopsy in Central Africa.

Tuberculous lymphadenitis of the neck: Case series

“…A new component has been introduced to the epidemiology of tuberculosis with the advent of HIV infection with extra pulmonary TB including lymphatic TB being more common [4,5]. Our recent experience with 3 cases of extra pulmonary TB with cervical lymphadenopathy in non-HIV patients seen within 4 months is reported and may be in keeping with the reported increase in extra pulmonary TB in recent years [3,6].…”

“…Rates of systemic symptoms vary depending on the geographic origin and case selection, we did not record any convincing systemic symptoms in a patient, however all the patients had evidence of concomitant pulmonary TB as shown on their chest radiographs, this is reported to be found in 18-42% of patients [1]. Tuberculous lymphadenopathy is reported in a study to be rare above the age of 45 years with women more affected than men [4,9]. All our patients were females; however, 2 patients were above 45 years in keeping with another study that stated that the lesion though common in the 2 nd decade might affect patients of any age [2].…”

Pathology of peripheral lymph node biopsies in Kano, Northern Nigeria

“…Benign lesions were more preponderant comprising 57% of peripheral node enlargement, which is also consistent with all other studies. [2][3][4][5][6][7][8][9] Cervical lymph node enlargement was most frequently due to tuberculosis that is also the commonest cause of all lymphadenopathy in this series accounting for 29.5%. This is comparable to other Nigerian centres -26% in Ibadan, 12 31.4% in Ilorin, 5 33% in Jos 6 and 33% in Maiduguri 7 but much lower than 47.8% in Ethiopia 8 and 52% in Zambia.…”

“…1 Published reports from within and outside Nigeria document a preponderance of non-neoplastic lesions with non-specific reactive hyperplasia predominating in the developed world, and tuberculosis the leading cause in Africa particularly with the current HIV/AIDS pandemic. [2][3][4][5][6][7][8][9] HIV not only directly causes lymphadenopathy but is also an indirect cause via several AIDS-defining illnesses. 10 Clinically, lymphadenopathy may be peripheral or visceral.…”

Non-caseating submental tuberculous lymphadenopathy: A case report

“…The emergence of HIV introduced a new component to the epidemiology of TB with extra pulmonary TB including lymphadenopathy TB being more common [7]. Several reports from the tropics describe TB and other infectious aetiology as major causes of lymph node enlargement [8].…”