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Category: Volume 06 Issue 12 December 2018
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Title: Clinico-pathological profile of Sub acute and Chronic Cervical Lymphadenopathy: A Prospective study

Authors: Dr Hemraj Satpute, Dr Shashikant Dorkar

 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.77

Abstract

Introduction: Cervical lymphadenopathy (CL) is one of the most common causes of consultations in ENT Out Patient Department. The differential diagnosis of CL is broad and the most common cause of CL, particularly in pediatric age group, is due to benign and self-limiting diseases such as viralinfections. The other common causes of CL in children include pyogenic or tubercular lymphadenitis. In adults and elderly patients it may be due to more sinister pathologies suchas lymphomas, leukemia and nodal metastasis. Less common causes of CL include autoimmune disorders (SLE and Sjogrens), plasma cell granuloma and histiocytosis.

Materials and Methods: Present study is a prospective cohort study in which 80 patients, above 12 years of age, attending ENT OPD for cervical lymphadenopathy were included on the basis of a pre-defined inclusion and exclusion criteria. A detailed history was taken and clinical examination was done in all the cases. Imaging studies were done whenever needed. FNAC followed by histopathological examination was done in all the cases. Patients in whom lymphadenopathy subsided after 10 days of antibiotics therapy or 14 days of conservative management were excluded from the study. The data was analysed using SSPE 16 software. For statistical purposes P value less than 0.05 was taken as significant.

Results: After excluding the patients in whom cervical lymphadenopathy subsided within 2 weeks the most common cause was found to be tubercular lymphadenitis (52.50 %). The other causes of cervical lymphadenopathy included chronic non-specific lymphadenitis (27.50%) and reactive lymphadenitis (12.50%). Uncommon causes of cervical lymphadenopathy included metastatic spread from primary malignancies and lymphoma (7.50 %). FNAC was found to be fairy reliable in diagnosis of etiology of lymphadenopathy.

Conclusion: Tubercular, non-specific and reactive lymphadenitis were found to be the most common benign causes of cervical lymphadenopathy. In elderly metastatic spread from primary malignant lesions was common cause. FNAC is an excellent diagnostic tool for establishing the etiological diagnosis of cervical lymphadenopathy.

Keywords: Cervical Lymphadenopathy, Etiology, Fine needle Aspiration Cytology, Metastatic Nodes.

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Corresponding Author

Dr Hemraj Satpute

Assistant Professor, Department of ENT, Bharati Vidyapeeth Deemed (To be) University

Medical College and Hospital Sangli- Maharashtra (India)