A clinicopathological study on cervical lymphadenopathy: an institutional experience

Abstract

Background: Despite advances in modern technology accurate diagnosis of cause of cervical lymphadenopathy remains a challenge. It leads to substantial morbidity to patients and sometimes even mortality. Uncertainty in diagnosis can lead to wrong diagnosis and increases cost of treatment. The objective of the study was to conduct a detailed evaluation of cervical lymphadenopathy in tertiary care set up and to enumerate the causes so that appropriate and adequate treatment can be initiated to reduce the morbidity.Methods: A prospective study was carried out on 100 patients of cervical lymphadenopathy and were evaluated clinically. Detailed history was taken of every patient followed by physical examination and appropriate investigations. This was followed by disease specific treatment and surgical intervention wherever necessary. Patient data was collected and evaluated to draw conclusions.Results: Most patients were young (between 12-40 years). Most common cause for cervical lymphadenopathy is due to non-neoplastic (82%) and less commonly from neoplastic (18 %). In non-neoplastic causes most, common cause is due to tuberculosis (51 %). In neoplastic causes, most common cause is due to lymphoma (10 %).  In tubercular lymphadenitis the posterior triangle group was the most commonly involved group of cervical lymph nodes (31.3%), followed by upper jugular group (21.5%). FNAC by virtue of it being inexpensive, quick in getting the results and easy to perform, is one of the important and essential diagnostic procedure.  Surgery should be to diagnostic biopsy, for treatment of abscess/sinuses and for a lymph node that do not resolve with chemotherapy and as an adjuvant to chemotherapy.Conclusions: Cervical lymphadenopathy can have varied manifestation from non-neoplastic to neoplastic condition. Proper history examination and relevant investigations and disease specific treatment can only cure the patient and improve the prognosis.