Extrapulmonary Pneumocystitis carinii is an uncommon and probably underdiagnosed complication of pulmonary P. carinii infections. We report the cytologic diagnosis of a case of P. carinii lymphadenitis which presented, without concurrent or historical pneumonitis, in a human immunodeficiency virus (HIV) positive patient who was taking aerosolized pentamidine. The diagnosis was suggested by abundant granular exudate on the cell block. Only scant, fragmented, irregular-shaped granular exudate was present on the direct smears and the Millipore filter preparation. The diagnosis was confirmed by special stains on the cell block.