Abstract

BACKGROUND “Lymphadenopathy’’ refers to nodes that are abnormal in size, consistency, or number. It is designated as generalised’’ if lymph-nodes are enlarged in two or more non-contiguous areas. Approximately three fourths of patients presenting with unexplained lymph-node enlargement have localised lymphadenopathy, whereas one fourth have generalised lymphadenopathy. In the present study an attempt is made to identify and categorise various neoplastic versus nonneoplastic lesions in patients presenting with generalised lymphadenopathy in a tertiary care centre.METHODS A cross sectional study of 100 lymph-node biopsies was conducted. After adequate fixation in 10 % formalin, tissues were routinely processed and stained with haematoxylin and eosin (H & E). Special stains like Ziehl-Neelsen and reticulin were employed whenever indicated. Immunohistochemistry (IHC) was performed for all neoplastic lesions and for some cases of non-neoplastic lesions. RESULTS Amongst 100 cases of lymph node biopsies analysed in this study, 71 cases were non-neoplastic and 29 were neoplastic. The most common non-neoplastic lesion observed was granulomatous lymphadenitis (32 cases), followed by reactive lymphadenitis (20). 25 cases of non-Hodgkin lymphoma (NHL) and 4 cases of Hodgkin lymphoma were observed in the neoplastic group. In the age range of 4.5 to 77 years included in the study, major bulk of cases was found in the age group of 11 - 20 years; out of this, 78.9 % were non neoplastic and 21.1 % were neoplastic. It was observed that 100 % of cases in the age group below 10 years were non-neoplastic, whereas in the age group above 70 years, all cases were neoplastic. CONCLUSIONS Granulomatous lymphadenitis was the most common lesion observed, probably because of high incidence of tuberculosis in this part of state. Morphological evaluation by light microscopy supplemented by special stains and IHC are necessary for establishing final diagnosis of generalised lymphadenopathy. KEYWORDS Generalised Lymphadenopathy, Haematoxylin and Eosin, IHC, Granulomatous Lymphadenitis, Kikuchi Fujimoto Lymphadenopathy, Hodgkin Lymphoma, NonHodgkin Lymphoma

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