DOI: http://dx.doi.org/10.18203/2349-2902.isj20194444

A clinicopathological study of cervical lymphadenopathy

Avijeet Mukherjee, Vikram Ramamurthy

Abstract


Background: Lymphadenopathy is a very common clinical manifestation of many diseases. It is defined as an abnormality in the size of character of lymph nodes, caused by the invasion or propagation of either inflammatory cells or neoplastic cells into the node. The study intends to find out systematically the various pathological conditions presenting with enlarged lymph nodes in the neck, also the various nodes of clinical presentations and behaviors of these conditional.

Methods: The clinical material consists of all inpatients and outpatients presenting to department of General Surgery. The study was conducted during the period from January 2017 to June 2018. This study consisted of 50 consecutive cases and diagnosis was made on the basis of clinical and histopathological findings. Patients, in whom FNAC and/or biopsy of enlarged node could not be carried out, were excluded.

Results: Out of 50 cases in the study, 76% were non-neoplastic. 44% of the cases were due to tuberculosis. Majority of the cases were in 3rd and 4th decade of age. After swelling in the neck, pain and fever were the most common presentation.

Conclusions: In the present study, non-neoplastic accounted for 76% of cases, 44% turned out to be tuberculosis and 30% reactive lymphadenitis. Among the neoplastic lesions, malignant secondaries accounted for 16% while non-Hodgkin’s lymphoma and Hodgkin’s lymphoma accounted for 6% and 2% respectively. In this present study, fine needle aspiration cytology was found to be reliable and cheapest method of diagnosis without any significant morbidity and with good patient compliance.


Keywords


Cervical lymph nodes, Lymphadenopathy, Tuberculosis, Fine needle aspiration cytology, Biopsy

Full Text:

PDF

References


Williams PL. Gray’s Anatomy. 38th ed. New York: Churchill Livingstone; 1995: 1608-1609.

Russel RCG, Williams NS, Bulstrode CJK. Bailery & Love’s Short Practice of Surgery, 23rd ed. London, 2000: 704.

Bielamowicz SA, Storper IS, Jabour BA. Spaces and Triangles of Head & Neck Head Neck, 1994;164:383-8.

Symmers HK. Lymph Nodes, Systemic Pathology. 3rd ed. Philadelphia: Churchill Livingstone, 1992: 142-325.

Kumar P, Clark M. Hematological Malignancies, 5th ed In: Kumar and Clark clinical Medicine. Edinburgh: WB Saunders; 2002: 496-500.

Shafullah Syed H. Tuberculous lymphadenitis on Afghan refugees. J Pathol. 1999;187:28-38.

Jha BC, Nagarkar NM, Gupta R, Sighal S. Cervical tubercular lymphadenopathy changing clinical patterns and concepts in management. Postgraduate Med J. 2001;77(905):185-7.

Tripathi KD. Antituberculous. 6th ed. Chapter 55. In: Drugs Essentials of Medical Pharmacology. New Delhi: Jaypee Brothers Medical Publication; 2008: 739-50.

Baskosa DK, Prasad R Kumar, Sinha B, Amaty RC. Distribution of lymph nodes in the neck in cases of cervical lymphadenitis. Acta Orolaryngeal, 2004;124(90):1095-8.

Gutenshon N, Cole P. Epidemiology of Hodgkin’s disease. Seminars in oncology 1980;7:285-7.

Walter J Urba, Dan L Longo. Hodgkin’s Disease. N Eng J Med. 1992;326:678-87.

Linderman SD, Jerome AH. Clarithromycin as a single modality treatment in mocobacterial Avium – intracellular infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod.. 1999;87(1):50-4.

Osama G, Peter R, Charles E, Joseph J. Metastatic malignant disease of unknown origin. Am J Surg Pathol. 2010;145:493-7.

Dandapat MC, Mishra BM, Dash SP, Kar PK. Peripheral lymph node tuberculosis: A review of 80 cases. Br J Surg. 1990;77(8):911-2.

Dasgupta A, Ghosh RN, Poddar AK. FNAC in diagnosis of superficial lymphadenopathy: An analysis of 2418 cases. Diag Cytopathol. 1996;15(5):382-6.

Bedi DG, Krishnamurthy R, Krishnamurthy S, Edeiken BS, Le-Petross H, Fornage BD, et al. Cortical morphologic features of axillary lymph nodes as a predictor of metastasis in breast cancer: in vitro sonographic study. Am J Roentgenol. 2008;191:646–52.

Ammari FF, Bani Hani AH, Gharibeh KI. Tuberculosis of lymph glands of neck - A limited role for surgery. Orolaryngeal. Head Neck Surgery. 2003;128(4):576-80.

Dworski I. Tuberculosis of cervical lymph nodes. Plunce Bolesti. 1989;41(3-4):169-71.

Purohit MR, Mustafa T, Morkve O, Sviland L. Gender differences in the clinical diagnosis of tuberculous lymphadenitis - A hospital based study from central India. Int J Infec Dis. 2009;13(5):600-5.

Aggarwal P, Wali JP, Singh S, Handa R, Wig N, Biswas A. A clinico-bacteriological study of peripheral tuberculous lymphadenitis. J Assoc Physicians India. 2001;49:808-12.