RESUMO
Objectives: To determine the frequency and pattern of presentation of Hodgkin's lymphoma in cervical lymph node at Liaquat University Hospital, and to see its pathological variants. Study design: Case series. Study Setting: Surgical departments of Liaquat University Hospital. Study Duration: Five years from January 2000 to December 2004
Sampling: Non-probable purposive. Inclusion Criteria: All patients of cervical lymph node enlargement of more than four weeks duration irrespective of age and sex. Exclusion Criteria: Cervical lymph node less than 1cm. Study Variables: Study variables used were age, sex, symptom, clinical finding, stage and histopathology. Data Analysis: Data analysis was done by using SPSS version 10
Results: A total of 500 patients with enlarged cervical lymph nodes were studied, amongst them 40 [8%] patients were diagnosed with Hodgkin's lymphoma [32 males and 8 females]. Mean age of 40 patients was 23 years [range 9-44 years]. Out of these 40 patients, in 8 [20%] patients it was difficult to differentiate lymphoma clinically from tuberculosis on clinical examination. Cervical swelling was the commonest symptom [100%] while fever, night sweats and weight-loss were present in 45% patients, 55% of patients were in stage III and IV [advance disease]. Mixed cellularity was the commonest histological variant. All 40 patients after diagnosis and staging were referred to Nuclear Institute of Medical Radiotherapy for further management
Conclusion: Although tuberculous cervical lymph node enlargement is very common, but Hodgkin's lymphoma has a definite possibility of occurrence [8% in our study]. Therefore all patients with enlarged cervical lymph node should not be treated with anti-tuberculosis therapy on empirical basis. Diagnosis should be confirmed by biopsy, otherwise patients may land up with advanced stage of Hodgkin's lymphoma with poor prognosis