Objective : To analyse the causes of abdominal lymphadenopathy in AIDS patients and evaluate the performance success rate,diagnostic yielding rate and safety of ultrasound(US)-guided fine needle aspiration ( FNA).
Material and Method : Medical records of HIV seropositive with abdominal lymphadenopathy who underwent percutaenous US-guided FNA from August 1997 to January 2002 were retrospectively reviewed. Records of clinical and ultrasonographic findings, numbers of FNA performed, numbers of obtained specimen, laboratory results and postoperative problems were analysed. Performance success is defined as obtaining a specimen while diagnostic yielding is performance success with laboratory result.
Results : FNA was done 72 times in 71 patients obtaining specimens in 68 cases (performance success rate = 94.4 %) with positive laboratory result in 63 cases ( diagnostic yielding rate = 87.5%). The culture gave results in 56 cases; M. tuberculosis(TB)=36, TB with other organisms = 5, Mycobacterium avium complex = 2, Nontuberculous mycobacterium =10, C.neoformans = 1,Salmonella with positive fungal stin= 1, E.coli with P. mirabilis =1. Five cases had positive AFB without culture specimen and one revealed positive AFB stain but negative culture. Lymphoma was found in only one case. No postoperative hemorrhage, peritonitis or perforated bowel in patient or needle stick injury to medical staff was reported.
Conclusion : Abdominal lymphadenopathy at Bamrasnaradura Hospital is mostly caused by TB and the second most common is nontuberculous mycobacterium. Percutaneous FNA under US guidance could yield definite diagnosis with a high performance success rate, high diagnostic yielding rate and was safe.
Keyword : Abdominal lymph node, Ultrasound, Needle aspiration, AIDS