Background: HIV is associated with an increased risk of aggressive lymphomas. Lymphadenopathy is common at the time of presentation; therefore, we set out to understand the time to lymphoma diagnosis in people with HIV (PWH) undergoing fine needle aspiration (FNA). Methods: A prospective, observational cohort of PWH, age ≥ 18 years, undergoing FNA in Soweto, South Africa was established between September 2021 and December 2022. Participants were followed up for up to 8 months and provided consent for a medical record review. Results: One hundred and forty-six participants were enrolled, including 76 females (52%) with a median age of 40 years and a median CD4 count of 216 cells/μL. TB was the most common diagnosis (n= 62; 42%), followed by lymphoma (n= 21; 14%), of whom 10 (48%) died either prior to diagnosis or initiating chemotherapy. An additional 2 participants (10%) were still awaiting a biopsy confirmation at 8 months. One participant’s FNA was suggestive of both lymphoma and TB. The median healthcare provider interval, the time from presentation to diagnosis, was 85 days. Conclusions: While TB was the most common diagnosis among PWH undergoing FNA, lymphoma was the leading cause of death. As most deaths occurred prior to chemotherapy, interventions to expedite a lymphoma diagnosis in this high-risk population are needed.
背景：HIV感染与侵袭性淋巴瘤风险增加相关。患者就诊时淋巴结肿大较为常见，因此本研究旨在探讨HIV感染者接受细针穿刺活检后至淋巴瘤确诊的时间间隔。方法：于2021年9月至2022年12月期间，在南非索韦托建立前瞻性观察队列，纳入年龄≥18岁、接受细针穿刺活检的HIV感染者。对参与者进行长达8个月的随访，并获得病历审查知情同意。结果：共纳入146名参与者，其中女性76人（52%），中位年龄40岁，中位CD4计数为216细胞/μL。结核病是最常见诊断（62例，42%），其次为淋巴瘤（21例，14%），其中10例（48%）在确诊或开始化疗前死亡。另有2名参与者（10%）在8个月随访期结束时仍在等待活检确诊。1例参与者的细针穿刺结果同时提示淋巴瘤与结核可能。从就诊至确诊的中位医疗系统间隔时间为85天。结论：在接受细针穿刺活检的HIV感染者中，虽然结核病是最常见诊断，但淋巴瘤是主要死亡原因。鉴于多数死亡发生在化疗开始前，有必要针对这一高危人群制定加速淋巴瘤诊断的干预措施。
肿瘤(癌症)患者之家