Spectrum of lymph node lesions as determined by histopathology

Abstract

Background and Objective: Lymph node lesions form a wide range of spectrum, exhibiting manifestations in both hematopoietic tissue and lympho reticular system. It is necessary to document the same spectrum in a particular region to understand the trend and diseases occurring frequently in that region. The range encompasses benign reactive changes to frank malignant lymphoma and metastatic deposits. Histopathology is considered to be the gold standard and its relevance to clinical diagnosis is studied here. Materials and Methods: A total of 200 cases were studied retrospectively in this study. Samples received were either biopsy or node resection specimens, and clinical history was recorded for each of them. Immunohistochemistry and special stains were performed as and when required. Results: Clinical diagnosis had a diagnostic accuracy of 71% approximately using histopathology as the gold standard. Most of the benign diseases were either reactive or tubercular lymphadenitis, whereas non-Hodgkin Follicular lymphoma had the maximum incidence among lymphomas. Conclusion: This study concluded that cervical group of superficial lymph nodes are most frequently encountered as palpable nodal swellings. The clinical suspicion of malignancy remains high in most of the cases due to the matted and enlarged presentation of lymph nodes. Histopathology revealed that only 33.5% of the cases to be malignant of which the most common was Follicular Lymphoma (non-Hodgkin type). The clinical accuracy of diagnosing malignant lesions thus coming to 71% approximately.