A Clinicopathological Study of Cervical Lymphadenopathy

Abstract

BACKGROUND AND OBJECTIVE: Cervical lymphadenopathy is the most common site of peripheral lymphadenopathy and is frequently encountered in otorhinolaryngology practice. Assessment and predicting its clinical behavior is not an easy task. Fine needle aspiration cytology (FNAC) is being routinely adopted as a special technique to diagnose the cause of lymphadenopathy. This study was undertaken to identify the clinic-demographic parameters in distribution of cases of cervical lymphadenopathy. FNAC was evaluated as a diagnostic tool by corroborating its results with histopathological examination of the excised lymph nodes. MATERIAL AND METHODS: This study was carried out at Hi-Tech Medical College and Hospital, Bhubaneswar, on 100 patients of cervical lymphadenopathy, over a period of two years. Along with detailed history, meticulous clinical examinations and investigations were performed. In all cases the diagnosis provided by FNAC and histopathology examination of the excised lymph node were correlated. RESULTS: Tuberculosis (45%) was the most common cause of cervical lymphadenopathy, followed by reactive (26%) and metastatic secondaries (21%) and lymphoma (8%). Maximum presentation was in 3 rd decade (22%) and bilateral involvement was seen in 20% cases. Posterior triangle was the most common site involved (45%). Overall diagnostic accuracy of FNAC was 92%. CONCLUSION: Most common cause of cervical lymphadenopathy are tuberculosis, reactive lymphadenitis and metastatic secondaries. FNAC is a cheap, quick, readily available and dependable diagnostic modality and can be used as a first line investigatory tool in outdoor departments.

Clinico-pathological evaluation of neck swellings at our tertiary care hospital

“…In our study, the age incidence of neck masses ranged from 1 year to 67 years, incidence of neck masses was highest in 21-30 years age group. This is in accordance with the studies by Narang RK, Surapaneni SL, Maheshwari A, Shariff M A et al 6,7,8,9 highest age incidence of neck masses in their study was in 3rd decade of life. Neck masses can occur in any age group, though its incidence tends to be common in younger age group because of relatively high occurrence of infective conditions like tuberculosis and reactive lymphadenitis in our country.…”

“…Amongst the salivary gland lesions, the parotid was the most commonly involved gland. Pleomorphic adenomas were 62.5 % of the cases in the present study similar to the study done by Surapaneni SL 7 , with 50 % cases of all salivary gland lesions. Pleomorphic adenomas were common in the 20-30 age group with female predisposition.…”

“…In our study, 58 cases (58%) had unilateral neck mass which is in accordance with the study by Ragesh KP et al 12 where 66% of the cases had unilateral neck mass. In our study, anterior part of the neck was involved in majority of cases which is similar to the studies conducted by Surapaneni SL et al, Soni S et al 7,11 On basis of etiology, lymph node masses constituted the majority of neck masses in 38 cases (38%) and amongst them tuberculous lymphadenitis was the most common cause. Tubercular lymphadenitis cases were 20 forming 20% of total cases and 52.8% of all lymph node masses.…”

Peripheral Lymph Glands; Are We Justified in Taking These Out for Histopathology in Our Patients?

“…12,13 Another study from India shows the incidence of tuberculosis about 70% and the reactive hyperplasia to be 13%. 4,14,15 These local and international results favour the tuberculous adenitis as the most frequent cause of peripheral gland enlargement and the paucity of evidence in favour of reactive hyperplasia as the commonest diagnosis makes us consider the reason for this change or plan a further study to support our findings.…”