Clinical and Biological Approach to Peripheral Lymphadenopathy in Adults from a Tertiary Care Centre in Lubumbashi (D. R Congo)

Abstract

Introduction: Superficial lymphadenopathy is a frequent reason for consultation in Internal Medicine. The diagnosis approach even done by a meticulous clinical examination has to be completed with investigations such as medical imagery and pathologic study. In low-income countries like Democratic Republic of Congo, means for proper diagnosis remain hardly accessible for some classes of the society. Thus, our study aims to describe socioeconomic , clinical and biologic parameter that can give diagnosis orientation in patients with superficial lymphadenopathy as observed in the department of internal medicine at the University of Lubumbashi Clinics (DR Congo). Patients, Material and Method: This is a descriptive, transversal study on superficial lymphadenopathy observed for a period of 24 months from November 2013 to October 2015 at the University of Lubumbashi Clinics. Parameters studied included gender, age, localization and clinical characteristics of superficial lymphadenopathy; biologic parameters and pathologic diagnosis were determined by lymph nodes biopsy. Results: 36 patients data were captured and non-Hodgkin lymphoma is the most frequent pathologic diagnosis (47.20%) followed by reactive hyperplasia (27.80%) and infectious lymphadenitis (19.40%). Some of the variables studied presented a significant statistical association and included age ≥ 50 years old (p = 0.0247), inguinal location (p = 0.0053), multifocal location (p = 0.0063), sensible character (p = 0.0391) and leukocytosis (p = 0.0022) for non-Hodgkin lymphoma and variables like age below 50 years (p = 0.0345), inguinal location (p = 0.0299) and sensible character (p = 0.394) for reactive hyperplasia. Conclusion: The C. Kakisingi et al.

Spectrum of inflammatory lesions in superficial lymph node biopsies in Uyo, Nigeria (2007 to 2015)

“…The incidence of tuberculous lymphadenitis varies with geographic variation and immunological status of the patients with high percentage being recorded in areas where there is occurrence of low socioeconomic status and poor standard of living (1,10,13). In addition, recent upsurge in incidence of HIV infection has contributed greatly to the re-emergence of tuberculosis in most developing countries including Nigeria (1,3,4,6,(15)(16)(17). The preponderance of tuberculosis in first three decades of life in most studies is consistent with the fact that primary tuberculosis, the commonest type in childhood and adolescence chiefly involves lymph nodes (5).…”

“…The lymph node appears spheroidal, ovoid or reniform in shape and has a delicate fibrous capsule; it is composed of lymphadenoid parenchyma, the lymphadenoid follicles and the lymphatic sinusoids mainly (3,4). Despite its protective function, lymph node is not free from a spectrum of diseases including acute lymphadenitis, chronic lymphadenitis, reticuloses and lipodystrophies, primary l y m p h a d e n o p a t h i e s , s e c o n d a r y lymphadenopathies, drug reactions (including certain vaccines), and nonneoplastic lymphoproliferative disorders such as Castleman and Rosai Dorfman diseases (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13).…”

“…Most of these pathologies in the lymph node are manifested as enlargement of the lymph node otherwise known as lymphadenopathy (1)(2)(3)(6)(7)(8)(9)(10)(14)(15)(16). Thus, lymphadenopathy (LAP) is a term used to describe the conditions in which lymph nodes become abnormal in size, consistency, and number (2,15,16).…”

“…Lymphadenopathy can be categorized clinically either as localized or generalized types (1)(2)(3)(6)(7)(8)(9)(10)(14)(15)(16). In another way, it can be classified clinically as either peripheral or visceral lymphadenopathies (5).…”

“…Of note, superficial nodes in the upper part of the body (cervical, supraclavicular, axillary) are preferentially biopsied than lower limb nodes (popliteal, inguinal or femoral) as the former are more likely to yield definitive diagnosis whereas the latter are often characterized by non-specific reactive or chronic inflammatory and fibrotic changes (5,17). The causes of peripheral or superficial lymphadenopathy are diverse and may either be obvious or obscure (3,6). The causes may be broadly grouped into neoplastic and nonneoplastic.…”