Mbata GC, Nweke IG, Egejuru RO, Omejua EG, Nwako OF, Chima EI and Oparaocha D
Background: In patients presenting with lymphadenopathy, evaluation of the biopsy specimen of accessible lymph nodes provides specific information to establish an early diagnosis which is important in the management of these patients.
Method: The study is a four–year (2010-2013) retrospective audit of all histologically diagnosed lymph node biopsies of 141 cases received at the Federal Medical Centre Owerri, Eastern Nigeria.
Results: Nearly one third 46(32.6%) of the 141 patients had reactive hyperplasia. Tuberculous lymphadenopathy 40(28.3%) and metastasis 27(19.7%) were other common causes. Non Hodgkins lymphoma was seen in 17(12%), while Hodgkins lymphoma was seen in 7(5%). Other cases seen were onchocerciasis 3(2.1%) and Rosai – Dorfman’s disease 1(0.7%). Acid–fast bacilli was demonstrated in 12/40(30%) of Tuberculous adenitis. All the patients with TB were screened for HIV and 14/40(35%) of them were HIV positive. Six patients had generalized lymphadenopathy and 4/6(66.6%) of them were HIV positive.
Conclusion: The differential diagnoses of lymphadenopathy are many. Tuberculosis and reactive hyperplasia have remained the predominant causes in our environment; followed by malignancy and lymphoma. Accurate diagnosis and early intervention is the key to good treatment outcome. Definitive histological classification using modern techniques like immunohistochemistry and cytogenetics should be made available in our tertiary hospitals.
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