Cytological diagnosis of primary lymph node infarction in a hiv infected individual: a rare finding

Lymph node infarction refers to a syndrome of spontaneous coagulative necrosis. One case of lymph node infarction will be encountered in every 450 lymph node biopsied lesions. It is a rare phenomenon associated with various neoplastic and nonneoplastic conditions. The non-neoplastic conditions include polyarteritis nodosa, viral infections (Parvovirus B19, Infectious mononucleosis), thrombosis, gold injections, fine needle aspiration cytology and finally may be idiopathic. The neoplastic lesions most commonly associated with infarction are malignant lymphoma and metastatic melanoma. Case report: A 40 year HIV infected male presented with fever, cough with expectoration and generalized weakness since 10 days and a solitary right axillary swelling measuring 2x1 cm, tender and mobile on palpation. Fine needle aspiration cytology of the lymph node was performed which revealed poorly preserved morphology of polymorphous population of lymphocytes with amorphous debris and focal areas of necrosis. Secondary causes for lymph node infarction like tuberculosis and fungal infections were ruled out by specific and systemic investigations. Conclusion: Fine needle aspiration cytology remains a very important tool for diagnosing the non-neoplastic and neoplastic lesions of lymph nodes.