Fine Needle Aspiration Cytological Findings In HIV Positive Patients Presenting With Head And Neck Masses At Kenyatta National Hospital

Abstract

Background: Head and neck masses commonly occur within the thyroid, salivary glands and lymph nodes as well as other soft tissues of the lesions. Lymphadenopathy is a common signs of Human Immunodeficiency Virus (HIV) infection or Acquired Immunodeficiency Syndrome (AIDS). In addition, persistent generalized lymphadenopathy is one of the earliest signs HIV infection. When malignancy is suspected, tissue sampling should be performed. Objective: To describe the fine needle aspiration cytological findings of accessible head and neck masses in Human Immunodeficiency Virus (HIV) positive patients attending selected outpatient clinics in Kenyatta National Hospital (KNH). Study design: This was a cross- sectional descriptive study. Study Population: The study was done among HIV patients attending ENT clinic, FNA clinic and CCC clinic at KNH presenting with head and neck masses. Materials and Method: The study included HIV patients undergoing fine needle aspiration cytology for various head and neck swellings. A total of 84 patients with lesions in the head and neck regions from the Ear, Nose and Throat (ENT) clinic, Comprehensive Care Centre clinic (CCC) and at the Fine needle aspiration (FNA) clinic were processed at the Cytology Laboratory at Kenyatta National Hospital. Using an aseptic technique, aspiration was done using gauge needle 23 or 25 with 10ml syringe in the usual manner. The material obtained was placed on the microscopic slide using a pick and smear technique. 4 thin slide smears, were made and 2 fixed in 95% alcohol immediately. The other 2 smears were air dried for staining using Romanowsky and Ziehl- Nielsen (ZN) stains. The 2 alcohol fixed smears were stained using Papanicolaou and Hematoxylin and Eosin stains. The air dried smears were stained with Ziehl Nielsen (ZN) and Giemsa stains for analysis of cases suspicious of TB or lymphoproliferative disorders. Univariate analyses were used to describe distribution in demographics and cytological findings. Bivariate analyses were used to compare distribution between variables; used Fisher’s exact for bivariate analyses: -used for categorical variable (presence/absence data); and on data with <5 observations per variable /category.