Abstract

Dr. Ufra Mateen, Dr. Sana Munir and Dr. Bareera Khan*

ABSTRACT

Background: Cervical lymphadenopathy is one the most common presenting complaint in the surgical OPD. Fine needle aspiration cytology (FNAC) has emerged as an important tool in the initial diagnosis and management of patients with lymphadenopathy due to early availability of results, simplicity of the test and minimal trauma to the patient. It is a safe, quick, reliable and cost-effective test for routine diagnosis of lymphadenopathy. Cervical lymphadenopathy is a very common complication of many diseases e.g. bacterial and viral infection, tuberculosis, lymphomas, malignancy and autoimmune diseases. Objective: To determine useful and important clinical signs and symptoms for evaluation of lymphadenopathy with consideration of histopathological findings of biopsy. 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 Bahawalpur Victoria Hospital. In 6 months of duration from May to October 2017. In this study total 130 cases were enrolled through non-probability consecutive sampling technique. 130 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 130 cases out of which, males were 76 (58.4%) and 54 (41.5%) females with mean age of 32±14.21 years. 54 had firm to hard consistency and 76 had soft or rubbery consistency. On lymph node biopsy, TB caseating necrosis was seen in 44 (33.8%) male patient and 34 (26%) female, 12 (9.2%) male and 8 (6.1%) female cases were found to have malignancy, chronic non-specific inflammation in 14 (10.7%) male and 10 (7.6%) female cases, Hodgkin lymphoma in 4 (3%) male and 2 (1.5%) female (3.33%) cases and non-Hodgkin lymphoma in 2 male patient. There were 22/130 patients in age group 15-35years, 32/130 cases in age group 36-55 years and 24 cases in 56-75 years diagnosed as TB. There were 8/130 patients in age group 15-35years, 10/130 cases in age group 36-55 years. 2/130 patients in age group 15-35years and 4/130 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.