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Lymph node pathology, how accurate is that?
Feb 7, 2001

Dear Doctor: I'm dying for some help, please answer. I had a lymph node biopsy done 2 months ago. my pathology reads: Histolotic sections show partial effacement of the normal lymph node architecture by mixed lymphocyte and histiocytic proliferation. These areas are associated with a relatively large amount of necrotic debris. However, no neutrophils are identified. The histologic features of this lymphoid proliferation, therefore, are consistent with histiocytic necrotizing lymphadenities ("Kikuchi's disease"). However, these same histologic findings can be seen in some patients with systemic lupus erythematosis. Thus, this patient should be evaluated clinically for that disease process. One month after unprotected sex with a man (who belongs to low risk group), both of us went to get tested and both of us were negative. My question is what are the chances that the man was in the window period at the time of my encounter and still wouldn't have seroconverted one month after the encounter? I was concerned and got tested because I begin developing lymph nodes in my neck and it stayed there for several months. Anyway, the lymph node biopsy was done three months after the encounter and eventually they were gone at four months after the encounter. How accurate are pathology findings done at a decent hospital? Please please tell me what are my chances of catching HIV. I did not have any other symptoms, and also, I was tested negative when I had the lymph node problem.

Response from Dr. Jackson

If the HIV test was done 3 months after the encounter then it is very very unlikely that you are HIV infected since most people will become HIV antibody positive 4-6 weeks later. Considering your partner also tested negative and is at low risk, I really do not think you are infected unless you have had recent high risk encounters. The lymph node pathology is unlikely related.

BJ


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