Chronic Nonspecific Lymphadenitis Research Articles

Age and Gender Differences with Clinical Presentation of Patients with Histopathological and CT-Scan Confirmed Parapharyngeal Mass

Background: Parapharyngeal Mass can occur in different age and gender group with varied clinical features. Objective: The purpose of the present study was to see the age and gender differences with clinical presentation of patients with histopathological and CT-scan confirmed parapharyngeal mass. Methodology: This was a cross sectional type of study. This study was carried out in the Department of Radiology and Imaging at Dhaka Medical College, Dhaka, Bangladesh. This study was carried out from January 2014 to December 2016. Clinically suspected cases of para pharyngeal space mass lesions attended in the otolaryngology and Radiology & Imaging department of Dhaka Medical College, Dhaka, Bangladesh were enrolled in this study. The patient in this study was evaluated according to the management plan for surgery followed in Otolaryngology department, which includes History, Clinical examination, CT-scan and Histopathology. Detail history about the illness, chief complains taken in formatted history sheet. All patients were undergone CT examination of neck in the Department of Radiology and Imaging at Dhaka Medical College, Dhaka. After resection of the mass, the specimen was sent to histopathological examination to the Department of Pathology at Dhaka Medical College, Dhaka, Bangladesh. Results: Male and female ratio was 2.57:1. Maximum 54% patients were belonged to 21-40 years’ age group followed by 38% 41 and above age group and 8.0% up to 20 years’ age group. Mean (±SD) age of the patients was 37.76 (14.82). Presence of mass, fever, malaise, pain, otalgia or fullness in ear, dysphagia, facial nerve dysfunction, trismus, dyspnea and deviation of tongue were the main presenting features of this study. Out of all lesions 58% were in left parapharyngeal space and 42% were in right. Of all patients, 20% had nerve sheath tumour (14% schwannoma & 6% neurofibroma), 6% had paraganglioma, 14% had chronic nonspecific lymphadenitis, 12% had tuberculosis, 16% had squamous cell carcinoma (invasion from adjacent spaces). Parotid pleomorphic adenoma (6%) & mucoepidermoid carcinoma (4%). Rests had, lipoma (4.0%), branchial cleft cyst (4.0%), lymphoma (6.0%), and abscess (2.0%). After histopathological evaluation 24% were malignant and 76% were benign. Conclusion: In conclusion majority of the study population are young adult male presented with mass, fever and malaise. Journal of Current and Advance Medical Research, January 2023;10(1):25-30

Analysis of causes of cervical lymphadenopathy using fine needle aspiration cytology and excision biopsy at tertiary hospital in India

Introduction: The presentation of cervical lymphadenopathy is common, but its diagnosis is sometimes difficult. Fine Needle Aspiration Cytology (FNAC) is a simple, inexpensive, rapid investigative procedure to confirm clinical diagnosis with minimal trauma and low complication rate.Aim: To determine the diagnostic accuracy of FNAC and to correlate diagnosis with FNAC and subsequent histopathological examination of excised biopsy specimens.Materials and Methods: The study was done from data collected from 2013 to 2015. Total 100 Patients with cervical lymphadenopathy were clinically evaluated and FNAC, excision biopsy were done and analysed.Results: FNAC is most sensitive in diagnosing secondary deposits in neck nodes with sensitivity of 88.9%. FNAC is least sensitive in diagnosing lymphomas with sensitivity of 78.6%.FNAC is 100% specific in diagnosing Tubercular lymphadenitis, Lymphomas and secondary deposits in neck nodes. FNAC is 96% specific in diagnosing chronic nonspecific lymphadenitis and 94% specific in diagnosing Reactive changes in cervical lymph node. Overall average sensitivity and specificity of FNAC of cervical lymphadenitis is 65% and 98% respectively.Conclusion: FNAC is a very useful diagnostic tool in patients having significant lymphadenopathy. The metastatic carcinomas, especially squamous cell carcinoma and tuberculous lymphadenopathy can be diagnosed by FNAC with a high degree of accuracy. There is significant limitation in the diagnosis of low grade Non-Hodgkin’s lymphoma from reactive hyperplasia.

Importance of fine needle aspiration cytology in revealing the spectrum of axillary swelling: An experience with 30 cases

FNAC plays an important role in the early diagnosis of the axillary swelling. This study was conducted to document the spectrum of lesions on the patients that came for FNAC with the complain of axillary swelling. Present study was carried out at the Department of Pathology. A total of 30 cases of axillary swelling which were referred for FNAC in the department of Pathology, over the period of 3 months were retrospectively evaluated. All the stained slides of the cases were also reviewed.: From 30 cases there were 13 males and 17 females. On examining the stained slides maximum number of cases presented with chronic granulomatous lymphadenitis followed by Reactive lymphadenitis , Lipoma, Ductal carcinoma metastasis of breast in axillary lymphnode, chronic non-specific lymphadenitis, One unusual case of Hydatid cyst who presenting with axillary swelling was also diagnosed. : FNAC is an important tool in differentiating benign and malignant lesions thus, helps in the proper management of the disease.

A clinicopathological study of cervical lymphadenopathy – A hospital-based cross-sectional study

Introduction: The enlargement of lymph nodes is an index of spread of infection and malignancy. Fine-needle aspiration cytology (FNAC) has the ability to provide rapid diagnosis and has good economic saving, reduces patient anxiety, and can be used for patients who have anesthetic risks. Aims and Objectives: The aim of the study is to study the various clinical presentations of cervical lymphadenopathy. Materials and Methods: This study was conducted from June 2019 to August 2020 over a period of 14 months. The study consists of 100 consecutive cases, both outpatients and inpatients at the surgical outpatient/wards at Malla Reddy Institute of Medical Sciences, Hyderabad. In all cases, FNAC was done. Excisional biopsy was done in all 100 cases. Results: The incidence of cervical lymphadenopathy was highest in the 12–40 years age group (73%). Males were more affected than females with a male-to-female ratio of 1.22:1. Tuberculosis was the most common etiology accounting for 51%. Posterior group of cervical lymph nodes were the most common to get involved in tuberculosis (31.3%). Sixteen cases out of 51 cases of tubercular lymphadenitis showed constitutional symptoms. The sensitivity of FNAC for tuberculosis – 86%, chronic nonspecific lymphadenitis – 73.3%, malignant secondaries – 87.5%, and lymphomas – 90%. Histopathological examination is the most dependable diagnostic tool. Conclusion: The most common disease affecting lymph nodes is tuberculosis. Dependence on clinical evidence alone would lead to erroneous diagnosis in most of the cases. FNAC is an important frontline investigation. Histopathological examination remains the most dependable diagnostic tool.

Disease Profiles of Head and Neck Lesions Diagnosed by Fine Needle Aspiration Cytology at a Tertiary Care Hospital in Bangladesh

Background: Head & Neck lesions encompass a multitude of congenital, inflammatory or neoplastic lesions including several anatomic sites and originating in different tissues and organs. FNAC is a simple, quick, feasible, cost effective and repeatable outpatient procedure with minimum risk of complications.
 Objective: The purpose of the present study was to study the spectrum of head & neck lesions attending in outpatient.
 Methodology: This present cross-sectional study included the patients presented with palpable head & neck swelling from January 2018 to September 2019 in outpatient (mostly ENT & HNS OPD) department of Monno Medical College & Hospital, Monno City, Gilondo, Manikgonj. Aspirates were done using mostly 5ml syringe and 23-gauge needle. Smears were stained with Papanicolaou stain.
 Results: Out of 210 patients of head & neck lesions studied, Lymph node (50.47%) was the predominant site aspirated with chronic nonspecific lymphadenitis & lymphoid hyperplasia being the commonest lesion. Thyroid lesions constituted 31.90% cases followed by soft tissue (11.9%) and salivary gland (5.71%).
 Conclusion: In conclusion FNAC is simple, quick, inexpensive and minimally invasive technique to diagnose different types of head and neck swelling. It could differentiate the infective process from neoplastic one and avoid unnecessary surgeries.
 Journal of Current and Advance Medical Research, January 2021;8(1):21-24

A study on incidence of cervical lymphadenopathy: An observational study

Aim and Objective: To study incidence of cervical lymphadenopathy between age, sex and disease. Methodology: A review of 100 cases of cervical lymphadenopathy from Shadan Institute of Medical Sciences, Hyderabad were used for analysis and discussion. Results: Tuberculous cervical lymphadenitis is the commonest disease affecting the cervical lymphnodes 50% followed by secondaries from various primaries 39%, non-specific 5%, Hodgkins lymphoma 4% and non Hodgekins lymphoma 2% were diseases commonly found to be effecting cervical lymphonodes in the study conducted above, we had no cases of cat scratch disease or toxoplasma gondi or other in the group. Heigher incidence of tuberculous cervical lymphadenitis in the age group between 11-40 years. The youngest in the series was 11 years, oldest its 66 years. Average age is 35 years. The male: female ratio is 1:1 in present series. Tuberculosis is a disease of the poor still holds good. In the present study 71% of patients belong to socioeconomically low income groups. Hindus were more commonly affected than Muslim which usually vice versa is explained due to the fact that Hindu population is more than Muslim population in the area when this study was conducted. Distribution of disease is more in rural area 67%. According to the present series, this could be due to increase the awareness of the disease and improvement in living condition of the population living in the urban area. Conclusion: There is very high incidence of tubercular cervical lymphadenitis in patients with enlarged neck nodes in developing countries like India. Cervical lymph node adenopathy constitutes the most common presentation of extra pulmonary form of tuberculosis. However, it mimics other pathological conditions like metastasis from other primary sites, reactive lymphadenitis, chronic non-specific lymphadenitis, lymphoma etc. Therefore, it is important that otolaryngologists are aware of tuberculosis in the head and neck region which can aid in early diagnosis with the help of simple investigations and subsequently patients can be managed promptly without delay.

Diagnostic Role of Lymphnode Imprint: A Cyto-histopathological Correlation

Introduction: Lymphadenopathy is a very common condition for which excision biopsy is often recommended when fine needle aspiration cytology is not conclusive. Lymph node imprint cytology is a useful and rapid alternative diagnostic tool. This study was conducted to assess the accuracy of lymph node imprint cytology as compared to the histopathology.Materials and Methods: Imprint smears were made from all cases of lymphadenopathy. The smears were evaluated by three pathologists and categorized into, inflammatory lesions and primary and metastatic tumors. Imprint smears were made from lymph node excision specimens and were stained with PAP and MGG stains. The diagnosis in imprints was compared with those given by histopathology. With the help of sensitivity, specificity & accuracy, the agreement between the imprint smear and histopathology was determined.Results: Among the total 92 cases, 40 (43.4%) cases were chronic non-specific lymphadenitis, 22 (23.9%) were tuberculosis and metastatic lesions each. The overall accuracy of lymph node imprint cytology was 96.73%, 96.74%, 96.74% and 100% for tuberculosis, chronic non-specific lymphadenitis, lymphoma, and metastatic lesions respectively.Conclusions: Lymph node imprint smears is a rapid diagnostic tool and can be used routinely as an adjunct to histopathology in the diagnosis of various lymph node disorders.

Cytomorphological study of lymph node lesions: a study of 250 cases

Introduction: Lymph node enlargement is frequent presentation in all age groups with a wide spectrum of diseases, ranging from infections to malignancy. Therefore, management of cases depends on lymph node pathology, which can be studied by collecting material through fine needle aspiration method that can be used as an outpatient procedure. Objectives: The study was undertaken to assess the cytomorphological features and incidence of various lymph node diseases on fine-needle aspiration cytology (FNAC) and to analyze the utility and diagnostic importance of FNAC in lymph node diseases. Materials and Methods: In the study, total of 250 patients were selected who had presented with lymph node enlargement at Department of Pathology in our Tertiary Care Centre. Results: In this series of FNAC, cervical lymph nodes were involved in majority of 171 (68.4%) cases. The age of patients ranged from 6 months to 92 years with slight male preponderance. Tubercular lymphadenitis comprised the majority (50.8%) followed by reactive lymphoid lesions (20.8%), metastatic malignancies and acute suppurative lymphadenitis (8.8%) each, granulomatous lymphadenitis (8.4%), chronic nonspecific lymphadenitis (1.2%), necrotizing lymphadenitis (0.8%) and lymphoma (0.4%). Conclusion: FNAC is a simple, safe, reliable, inexpensive and the most diagnostic tool in early detection of lymph node lesions.

Patterns of lymph node pathology using biopsy evaluation tool for lymphadenopathy: a retrospective descriptive study conducted at Al Hussein Medical City 2014–2016

Objective The study was assumed to determine the histopathological spectrum of lymphadenopathic specimens where was a common site and showed the age and gender variation of these lesion distribution.Methods It was a descriptive retrospective study wherein 130 cases of lymph node biopsy reports of specimens from patients 3 months to 81 years at Al Hussein Medical City between 1 January 2014 and 31 December 2016 were studied.Results A total of 130 lymph node biopsies were received of which female 58.46% (76 cases) and male 41.53% (54 cases), a male to female ratio of 1:1.4 and the P value 0.011 with significance difference. The age range was from 3 months to 81 years. Most cases were seen in the age group of 21–30 years (25 cases 19.23%). The non-neoplastic lesions were more common comprising 66.9% (87 cases) included 46.9% (61 cases) of chronic nonspecific lymphadenitis, tuberculosis lymphadenitis 18.46% (24 cases) and other lesions 1.5%, while the neoplastic lesions 33.07% (43 cases) included non-Hodgkin lymphoma 13.07% (17 cases), Hodgkin lymphoma 12.30% (16 cases) and secondary metastasis 7.69% (10 cases). The more common site was cervical 93.07% (121 cases), axillary 4.6% (6 cases), inguanal 1.5% (2 cases) and mesenteric 0.7% (1 case).Conclusions The most common pathological pattern seen was chronic nonspecific lymphadenopathy (46.6%) followed by tuberculosis lymphadenitis 18.46%, non-Hodgkin lymphoma 13.07%, Hodgkin lymphoma 12.30%, and secondary metastasis 7.69% and others 1.5%. It is more common in female than male, and the more common site is cervical lymphadenopathy 93.07%. The earlier diagnosis and management of tuberculosis and earlier diagnosis of malignancies before the onset of nodal metastases may explain the result.

Cervical lymphadenopathy: a clinicopathological study

<p class="abstract">Cervical lymphadenopathy is one of the commonest presentations of underlying pathology of the head and neck region which has large number of differential diagnosis like neoplasms, infections (specific and non-specific), immune deficiency disorders and rare disorders like Inflammation. Pseudotumour (plasma cell granuloma) and Kikuchi-Fujimoto disease.</p><p class="abstract"><strong>Methods:</strong> The present study is a prospective study conducted in our institution Dr B.A.M. Central Railway Hospital, Mumbai. Our study included 115 patients with cervical lymphadenopathy presenting with swelling of more than 1.5 cm size in longest diameter. All the patients included in our study are more than 12 years of age, in whom the lymph node did not regress after adequate antibiotic therapy in acute cases (i.e. Conservative management for at least 2 week), and all the chronic cervical lymphadenopathy patients. </p><p class="abstract"><strong>Results:</strong> Tuberculosis was found to be the most common cause of cervical Lymphadenopathy in 54.78% cases followed by reactive lymphadenitis in 22.61% cases, chronic nonspecific lymphadenitis in 12.17% cases and metastatic lymphadenopathy in 7.83% cases. Other causes were unknown primary in 1.74% cases and non-Hodgkin’s lymphoma in 0.87% cases. Sensitivity and specificity of FNAC was 79.36% and 100% respectively.</p><p><strong>Conclusions:</strong> Tuberculosis, reactive lymphadenitis and malignancy are the most important cause of cervical Lymphadenopathy. They present in different age groups with different clinical feature. Fine Needle Aspiration Cytology (FNAC) is extremely sensitive and highly specific investigation for early diagnosis</p>

Evaluation of fine needle aspiration cytology among lymphadenopathy patients in Ambedkarnagar, Uttar Pradesh, India

Background: Surgical fine needle aspiration cytology is most popular diagnostic aid in patients with lymphadenopathy.Methods: This one year observational study comprised of aspirate collected from lymph nodes of patients attending Mahamaya Rajkiya Allopathic Medical College and Hospital, Ambedkarnagar, Uttar Pradesh, India. Fine needle aspiration was performed in all the patients and slides were stained with H and E, PAP and Ziehl Neelsen stains. SPSS was used for data analysis. Fischer’s Exact test was applied.Results: Out of the 51 patients, the most common site of lymph node aspirated was cervical (72.5%). A higher proportion of cases were diagnosed as chronic nonspecific lymphadenitis (23.5%) followed by granulomatous abscess (23.5%), tubercular lymph node (21.6%) and reactive (17.6%). A significant association found between FNAC diagnosis and age was found (p≤ 0.05).Conclusions: FNAC is a simple and useful procedure in patients with lymphadenopathy.

A Clinicopathological Study of 100 Cases of Cervical Lymphadenopathy

Introduction: Cervical lymphadenopathy is one the most common presenting complaint in the surgical OPD. Fine needle aspiration cytology (FNAC) has emerged as an important tool in the initial diagnosis and management of patients with lymphadenopathy due to early availability of results, simplicity of the test and minimal trauma to the patient. It is a safe, quick, reliable and cost-effective test for routine diagnosis of lymphadenopathy. Aims and Objectives: To compare the FNAC findings with that of the histopathology in an attempt to highlight the diagnostic accuracy and reliability of FNAC of lymph nodes. Materials and Methods: The present study was a prospective study carried out in the department of General Surgery, Osmania General Hospital, Hyderabad, Telangana State, over a period of 21 months. The study group consisted of 100 consecutive patients, both out-patient as well as in-patients who presented with chief complaints of cervical lymphadenopathy. Fine needle aspiration cytology (FNAC) was done in all 100 patients. Excision biopsy was done in 84 cases. FNAC and biopsy findings were compared with clinical diagnosis. Results: Benign lesions were more common in cervical lymph nodes than malignant ones. Tuberculosis was the most common of all affecting predominantly the posterior group. Younger age and female predominance was seen in tuberculosis. Malignancies were more common in older age group. The overall accuracy of FNAC in diagnosis of cervical lymphadenopathy was found to be 82%. Conclusions: Fine needle aspiration cytology has higher accuracy for diagnosing tuberculous lymphadenitis, lymphomas, and secondary deposits. It has lesser accuracy for diagnosing chronic non-specific lymphadenitis. Thus, FNAC was found to be simple, cost effective, reliable and cheap method for diagnosis in cases of cervical lymphadenopathy.

Fine needle aspiration cytology for lymph nodes: a three-year study

Background and aims: The cytologic patterns of lymph node fine needle aspirations (FNAs) exhibit a wide variation in different diseases and in different ethnic groups in various geographical locations. Knowledge of lymphadenopathy patterns in a given geographical region is essential for making a confident diagnosis of suspected disease in that location. In the present study, we assessed the cytologic patterns of lymph node aspirations in patients in the Huangdao region of China.Methods: A three-year retrospective study design was conducted on FNA cytology samples from the lymph nodes of patients in our hospital between January 2011 and December 2014.Results: A total of 2136 lymph nodes were aspirated during the study period. Cytologic analysis of the lymph nodes revealed the following: malignancy, 53.6%; chronic non-specific lymphadenitis, 15.2%; reactive lymph node, 7.5%; pyogenic abscess, 2.9%; tuberculosis lymphadenitis, 8.7%; Hodgkin lymphoma, 4.8%; and non-Hodgkin lymphoma, 7.16%. The 30–50 year age group was the most affected age group, while lymphadenopathy in the >60 year age group was less frequent. Cervical lymph nodes were the most frequent site for lymphadenopathy in women (31.4%, p < 0.001) and men (49.1%, p < 0.001).Conclusions: Lymphadenopathy is associated with a wide range of disorders; however, metastatic lymph nodes of malignancies are the most common cause for enlarged lymph nodes.

Histomorphological spectrum of paediatric surgical lesions: experience at a tertiary care centre

Aim: The aim of this study is to understand the profile of paediatric surgical pathology specimens in our region. There is paucity of studies on the histologic review in India. Materials & Methods: This is a retrospective analysis of 462 cases of paediatric surgical specimens (Age group 0-12 years) in surgical pathology in a tertiary care centre encountered over a period of one and a half years. Results: Out of 462 cases, 353(76.41%) cases belonged to acquired conditions (both Non-neoplastic and Neoplastic), and 109 (23.59%) cases belonged to congenital and developmental conditions. Males constituted 62.55% while females 37.45%. Gastrointestinal tract was most commonly affected (40.26%) followed by head & neck region (26.19%) and renal & urogenital system (15.58% each). Among acquired conditions (Non-neoplastic and Neoplastic), the most common diagnosed condition was Appendicitis (27.19%) followed by Chronic tonsillitis (24.93%), Inguinal hernia (6.79%), Hydrocele (4.25%), Hemangioma (3.68%), Nonspecific lymphadenitis (3.39%), Empyema (2.83%), TB lymphadenitis and Juvenile polyp (2.55% each) etc. Among acquired neoplastic lesions, there were 4 cases of Wilms tumor, 4 cases of Osteochondroma, 1 case of Fibrous dysplasia, 2 cases of NHL, 1 case of Retinoblastoma, 6 cases of Lipoma and 1 case of Infantile rhabdomyosarcoma. Among congenital and developmental conditions, the most common condition was Hirschsprung’s disease (18.35%), Pelvic ureteric junction obstruction (11%), Meckel’s diverticulum & anorectal malformations (9.17% each), Testicular anomalies & enterogenous cyst (6.42% each) etc. Conclusion: The histopathological patterns of surgical pathology specimens in childhood differ from adults. There are very few published reports on histopathological profile of paediatric surgical pathology specimens in India. Hence, we conducted this study to characterize the histopathological types of surgical pathology specimens among the paediatric patients. Key

English

“A clinic – pathological study of neck swelling excluding thyroid” is a prospective study of 100 cases. The study was conducted with an objective to know the various etiological factors and clinical factors and clinical presentation of the neck swelling and also to correlate the clinical diagnosis with FNAC and histopathological reports. METHODS: The study was conducted in J.S.S. Hospital Mysore during study period i.e. from August 2005 to 2007. 100 patients with neck swellings exclusion criteria were included in this study. After a detail history and clinical examination of neck swellings, patient were subjected for FNAC to confirm the diagnosis. Biopsy of the lymph node was performed when FNAC either negative or doubtful to confirm the diagnosis by histoathological examination. The Age/Sex distribution, clinical presentation, the investigations, the treatment modalities, complications were all evaluated and compared with standard literature. RESULTS: A total 100 patients were enlisted in this study, tubercular cervical lymphadenitis accounted for 55%. Maximum distribution was observed in the age group of 1-20 year (41.8%) followed by 21-04(36.3%), with the age range being 1-80 years. Among them 21 were male patients and 32 females with the female to male ratio being 1.5:1.48 patients (87.3%) belonged to the lower socio economic group. The commonest group of lymph node region involved was the upper deep jugular group accounting for 70.9% followed by posterior triangle lymphnode region accounting for 18.2%. ESR was found to be elevated in all the patients. Sputum AEB was positive in 14 patients (25.5%). Chest x-ray of 25 patients (45.5%) showed evidence of pulmonary Koch’s FNAC was positive in 42 patient out of 46 patients, accuracy was 92%. FNAC was inconclusive in 4 patients and were subjected for lymphnode biopsy. Total of 13 patients underwent lymphnode biopsy. All patients received short course of chemotherapy with follow up at monthly interval. In our study, metastatsis in the cervical lymphnodes was the second commonest etiological factor among neck swellings, observed in 13 patient (13%). 11 were diagnosed as having sq cell ca and 2 as adeno ca. metastatic work up revealed the primary site for sq cell ca as tonsilar fossa, posterior pharynx, larynx accounting for 63.6%, 27.3% and 9.1% respectively. Out of 13 patients 11 were male and 2 females. All patients were subjected for FNAC with diagnostic accuracy of 100% 4 patients underwent FND. Out of these 4 patients, 2 patients were referred to higher centre for further management (chemo radiation) during follow up period. Two other patients didn’t turned for follow up. 16 patients were diagnosed as having lymphadenitis. FNAC showed evidence of acute lymphadenitis in 7 patients and chronic nonspecific lymphadenitis in 7 patients. In 2 patients FNAC was inconclusive, who were subjected for biopsy. HPE of these patients revealed chornic non specific lymphandenitis. 6 cases were diagnosed as having lymphoma with the maximum occurrence observed in the age group of 41-60 years. The usual presentation was painless cervical lymphdenopathy. Other neck swellings observed in our study were cystic hygroma in 4 patients, branchial cyst in 2 patients, and lipoma in 4 patients. CONSLUSION In our study TB lymphadenitis was the commonest cause for the neck swellings. Most of the cases studies were belonged to the low socioeconomic class. All the patients with tuberculosis did not show much constitutional symptoms, but few, patients presented with fever, cough, loss of weight, loss of appetite. Tuberculosis most commonly affects the upper deep cervical lymphnodes. The sex ratio in TB lymphadenitis was M : F (1:1.5) showing that female predominance. Radiologically majority of the patients usually did not show the evidence of pulmonary Kochs. All patients of TB lymphadenitis showed good response to 6 months chemotherapy, surgery was rarely required. FNAC & histopathological examination were the main tools in diagnosis of the neck swellings. Surgery played a role in other benign neck swellings like branchail cyst, cystic hygroma and lipoma.

Cytologic patterns of lymph node diseases in Hawassa University Referral Hospital, Southern Ethiopia

Background: Lymphadenopathy is becoming common pathological prblem in most part of the world. There is a wide variation in the pattern of disease in different ethinic groups and in various countries. The knowledge of the pattern of these diseases in a given geographical region is essential for making a confident diagnosis of suspecting a disease. Objective: The aim of this study was to assess the cytological patterns of lymph node diseases in patient attended Hawassa University referral hospital.Methods: A five years retrospective study was conducted on fine needle aspiration cytology report of patient referred to pathology laboratory of Hawassa University referral hospital from September, 2009 to September, 2014.Results: A total of 1,067 lymph nodes were aspirated in the study period. Cervical lymphadenophathy was the most frequent (48.82%) followed by submandibular (22.77%) lymph nodes. The second decade was the most affected age group while age group above 60 was less frequent. Tuberculosis lymphadenitis was highest (48.82%), chronic non-specific lymphadenitis (20.33%), reactive (16.21%), pyogenic abscess (5.99%) and the rest were malignant. Conclusion: Lymphadenopathy can be associated with a wide range of disorders however; tuberculosis lymphadenitis is the most common cause of enlarged lymph node in the study area.

Role of Fine Needle Aspiration Cytology of Cervical Lymphnode in Paediatric Age Group

Introduction: Lymphadenopathy is a common physical finding in childhood. Unexplained lymphnadenopathyin children is a major source of parental anxiety. This study was undertaken to evaluate the utility of Fine Needle Aspiration Cytology as a rapid diagnostic tool for cervical lymphadenopathy in paediatric age group. Methodology: Total 260 patients attending OPD at Dr.Shankarrao Chavan Govt Medical College, Nanded from January 2010 to December 2012 were studied. Summary of results: The age group ranged from 0-18 years. The commonest age group affected was 7-9 years. Male to female ratio was 1.1:1. Posterior triangle was the commonest site of lymphadenopathy 130 (50%) cases. On cytology, 122 (46.93%) cases were diagnosed as tuberculous lymphadenitis, 69 (26.54%) cases diagnosed as chronic non-specific lymphadenitis, 43 (16.54%) cases diagnosed as reactive lymphadenitis, 10 (3.85%) cases diagnosed as acute lymphadenitis, 12 (4.62) cases diagnosed as N.H.L, 02 (0.76%) cases diagnosed as hodgkin’s lymphoma, 01 (0.38%) cases diagnosed as suspicious for malignancy. Histopathological examination was possible in only 40 cases. The overall sensitivity observed was 100%, specificity 97.05% and accuracy was 97.56%. Conclusion: FNAC is a safe, simple, reliable, reproducible and cost effective procedure in the diagnosis of paediatric lymphadenopathy and is free from limitations of surgical biopsy.

Role of FNAC in diagnosis of cervical lymphadenopathy

Background: Fine Needle Aspiration Cytology (FNAC) is simple, quick, inexpensive and minimally invasive OPD technique used to diagnose different types of swellings located in the neck. Aims & Objective: (1) To assess the distribution of various cytomorphological patterns of cervical lymphadenopathy; (2) To assess the age specific distribution of various cytomorphological patterns of cervical lymphadenopathy. Materials and Methods: This study was carried out at GMERS Medical College and Hospital, Valsad, on 196 clinically diagnosed cases of cervical lymphadenopathy over a period of two years from January 2010 to December 2011.FNAC was carried out in all these patients. Fine Needle Aspiration Diagnosis was correlated with details of relevant clinical findings and investigation. Results: Total 196 cases were studied, out of these 173 (88.26%) were found inflammatory and 23 (11.73%) were neoplastic. Tuberculosis was the most common disease found in 109 (55.61%) patient followed by chronic nonspecific lymphadenitis 49 (25.00%), Metastatic tumours 21 (10.71%), acute lymphadenitis 15 (7.65%), Lymphoma 2 (1.02%). Highest incidence of cervical lymphadenopathy was found inpatients of 11 to 30 years age group. Conclusion: Fine Needle Aspiration Cytology is easy, simple, safe, reliable and non-invasive procedure for diagnosis of cervical lymphadenopathy and easy way for surgeon to decide whether to go for surgery or not.

Benign causes of 18-FDG uptake on whole body imaging

C OST-EFFECTIVENESS and high accuracy of whole body 1 8-Fluorodeoxyglucose positron emission tomography (18-FDG-PET) have been established for several malignancies. 2,3 However, pitfalls have been encountered due to variable degrees of 18-FDG uptake by benign pathology. 4-66 In the majority of the cases visual interpretation (slight uptake, irregular or diffuse pattern) and quantitative analysis with different cut-off values, along with the physical examination and radiological correlation, will clarify the underlying causes. The physiological and artifactual accumulation 4,67 in 18-FDG whole body scans, and the technical and biological factors causing false-positive results 15 have been reviewed recently. We report seven cases of 1 8-FDG uptake related to lactation (Fig 1), muscle artifact at the insertion of the Latissmus Dorsi (Fig 2), esophagitis (Fig 3), a tracheostomy tube (Fig 4), ectopic pelvic kidney (Fig 5), hydatid cyst (Fig 6), and chronic nonspecific lymphadenitis (sinus histiocytosis) (Fig 7). The following are the reported benign causes of 1 8-FDG uptake that should be considered in interpreting whole body scans to decrease the rate of false-positive results in oncologic patients.

Fine-needle aspiration cytology in the diagnosis of superficial lymphadenopathy: an analysis of 2,418 cases.

During a period of 5 yr, 2,418 fine-needle aspirations (FNA) were performed on 2,216 patients with superficial lymphadenopathy. Chronic nonspecific lymphadenitis was the commonest inflammatory lesion followed by tuberculosis. Among malignant lesions, metastatic tumors were most common followed by non-Hodgkin's lymphoma. The FNAC findings were correlated with subsequent histopathological diagnosis in 1,041 cases. The sensitivity rates of FNAC in tuberculosis, metastatic tumors, Hodgkin's disease, and non-Hodgkin's lymphoma were found to be 83.3, 97, 30, and 80.3%, respectively, the specificity being 94.3, 98.9, 98.6, and 95.4% in the same order. Immunocytochemical tests performed on the aspirated material helped in classifying the metastatic poorly differentiated tumors and confirming the diagnosis of non-Hodgkin's lymphomas. Effects of FNA on subsequent biopsy in 81 lymph nodes with benign hyperplasia were studied and showed that aspiration does not interfere with subsequent histologic assessment. Thus FNAC is a simple, inexpensive procedure, and when complemented by appropriate immunocytochemical studies is accurate and reliable for routine diagnosis of lymphadenopathy.