Abstract

Dr. Asfia Bashir, Dr. Hafiz Muhammad Sohaib and Dr. Amna Khan*

ABSTRACT

Background: Cervical lymphadenopathy is a very common complication of many diseases e.g. bacterial and viral infection, tuberculosis, lymphomas, malignancy and autoimmune diseases. In Pakistan, according to many studies the most common cause of cervical lymphadenopathy is tuberculosis. Because in our country prevalence of TB is very high as compared to western world Several investigations are usually done in order to establish the cause of lymphadenopathy but biopsy of the node is proven to be Gold standard. Objective: To determine the frequencies of various causes on lymph node biopsy in cases presenting with cervical lymphadenopathy. This would help doctor to get basic idea about prevalence of different clinical profiles of cervical lymphadenopathy for easier detection and better therapeutic outcomes. Methodology: It is a cross sectional study done at Nishtar Hospital Multan. In 7 months of duration from June 2017 to December 2017. In this study total 65 cases were enrolled through non-probability consecutive sampling technique. 65 cases of both genders falling in the age group of 15 to 75 years presenting with cervical lymph node enlargement were enrolled. These cases then underwent FNAC or surgical excision at the surgical department of the same institute. The results of biopsy were collected from Pathology department and the various outcomes were noted. Results: In this study there were total 65 cases out of which 38 (58.4%) were males and 27 (41.5%) females with mean age of 34±14.21 years. Out of 60 cases, 26 had firm to hard consistency and 37 had soft or rubbery consistency. On lymph node biopsy, TB was seen in 22 (33.8%) male and 17 (26%) female cases, malignancy in 6 (9.2%) male and 4 (6.1%) female cases, chronic non-specific inflammation in 7 (10.7%) male and 5 (7.6%) female cases, Hodgkin lymphoma in 2 (3%) male and 1 (1.5%) female (3.33%) cases and non-Hodgkin lymphoma in 1 male patient. There were 11/65 patients in age group 15-35years, 16/65 cases in age group 36-55 years and 12 cases in 56-75 years diagnosed as TB. There were 4/65 patients in age group 15-35years, 5/65 cases in age group 36-55 years and 3 cases in 56-75 years showed chronic non-specific inflammation on biopsy. There were 1/65 patients in age group 15-35years, 2/65 cases in age group 36-55 years and 7/65 cases in 56-75 years who were having malignant finding on lymph node biopsy. 1/65 patients in age group 15-35years and 2/65 cases in age group 36-55 years were having reed-Stenberg cells on lymph node biopsy result. Non-Hodgkin lymphoma was seen in the biopsy result of a 70 years old man. The constitutional sign and symptoms including fever, weight loss, night sweats and anemia were common in patient having TB and malignancy. Conclusion: Tuberculosis is the commonest presentation of cervical lymphadenopathy in our hospital and soft, rubbery and ulcerated consistency is significantly associated with this. Both genders are almost equally effective.