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Biopsy results; what is reactive lymphoid hyperplasia?
May 26, 2002

Hi, I tested positive three months ago, just before having a left axillary biopsy. I have low platelets, slight anemia and chronic fatigue, loss of concentration, low energy plus i've already had an assortment of mental health issues related to past childhood sexual abuse and drug use. I am clean/sober 4+years and non-smoker. I am in dire straits and having a hard time with being hiv+. My first cd4 was 151 and second was 374 w/viral load at 40k. Qusestion is, i never heard from my oncologist or primary care, who know of my HIV and when i asked about the biopsy results they did not return my calls. Yesterday i retrieved my records to bring with for when i see my new ID doctor this week. The biopsy diagnosis reads: Reactive lymphoid hyperplasia + features suggesting toxoplasmosis. What does that mean? Is it serious? Is it usual for the patient to be uninformed about it? Thank you.

Response from Dr. Dezube

You raise several issues-- the meaning of reactive lymphoid hyperplasia and the role of the mental health issues. I'll deal with each one separately.

In terms of the mental health issues, this takes precedence since good mental health is essential to prevent you from a relapse back into drug use. Given both the drug abuse isse and the childhood sexual abuse, I would highly highly recommend that you seek counselling if you have not already done so. A good mental health worker (social worker, psychologist, pyschiatrist, and so on) and/or proper medicines can help greatly in keeping you on the path of good health. Congratulations on your 4+ years of being clean and sober-- that's quite an acheivement of which you can be proud.

As for reactive lymphoid hyperplasia, this is VERY common in HIV patients. All this terminology means is that your lymph nodes are revved up in an attempt to fight off the HIV infection. This is a healthy sign. I'm not sure what to make of the "suggest toxoplasmosis". Toxoplasmosis is an infection which HIV patients can get. You mention that you will seeing a new ID doctor; I presume that s/he will evaluate further for the toxoplasmosis and settle whether your do or do not have it. Good luck! It sounds like things are moving in the right direction.

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