Cervical lymphadenopathy: diagnostic approach

ABSTRACT

To study the etiology of unexplained cervical lymphadenopathy of more than one month duration, not easily diagnosed on clinical ground or after simple investigations. This study was conducted at Postgraduate Medical Institute, Lady Reading Hospital, Peshawar from January 2003 to June 2004. A total of 100 patients with prolonged unexplained cervical lymphadenopathies were included in this study. All the patients were evaluated through detailed history and clinical examination. Beside these, laboratory, radiological, endoscopic examination, FNAC and histopathological studies were performed. Out of 100 cases, 54 [54%] were female and 46 [46%] male. Laboratory evidence revealed tuberculous lymphadenitis in 58 [58%] cases, metastatic lymph nodes in 18 [18%] cases, lymphoma in 18 [18%] cases, infectious mononucleosis in 3 [3%] cases and leukemias in 3 [3%] cases. Histopathology of the lymph nodes gave conclusive diagnosis with 100% sensitivity rate in cases of granulomatous lymphadenitis and lymphomas. Tuberculous lymphadenitis [58%] represented the commonest infectious aetiology in present study and carcinoma is less common as compared to the western figures. It is advised that any treatment for cervical lymphadenopathy should be preceded by histological proof