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I beg for your answer, Please
Jan 9, 2001

Dear Dr. Feinsberg:

couple of days ago, I posted a question about what kind of lymph nodes pathology report would resemble an HIV infection. I haven't got your answer yet.

In any case, 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.

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. Feinberg

Lymph node pathology will not reveal HIV unless special in situ hybridization tests specific for HIV are used. What the pathology will reveal with standard staining techniques depends on the stage of disease, and ranges from hypertrophic to involuted. For more detail, please consult a textbook. Detailing what these changes actually look like is far too technical and detailed for this forum.


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