Aetiology of peripheral lymphadenopathy in adults: analysis of 1724 cases seen at a tertiary care teaching hospital in southern India.
Natl Med J India
; 20(2): 78-80, 2007.
Article
in En
| MEDLINE
| ID: mdl-17802986
ABSTRACT
BACKGROUND:
In patients presenting with peripheral lymphadenopathy, excision biopsy of the most accessible lymph node provides material to establish an early diagnosis, and is important in the management of these patients.METHODS:
A retrospective study was done of 1724 lymph node biopsy specimens obtained from adult patients and submitted for histopathological examination over a 12-year period.RESULTS:
About one-third (n = 614; 35.6%) of these patients had non-specific lymphadenitis. This included a heterogeneous group of disorders comprising benign follicular hyperplasia, reactive hyperplasia, marked follicular hyperplasia and reactive sinus histiocytosis. Tuberculosis lymphadenitis (n = 540; 31.3%) and malignancy (n = 447; 25.9%) were the other common causes. Of the 540 patients with tuberculosis lymphadenitis, the human immunodeficiency virus (HIV) status was tested in 424 (78.5%) patients; of these, 34 patients (8%) were HIV-seropositive. Epithelioid granulomas with caseation necrosis were more frequently seen in HIV-seronegative patients compared with HIV-seropositive ones (chi2 = 54.66; p < 0.001 ). In HIV-seropositive patients, multiple sites of lymph node involvement (chi2 = 40.597; p < 0.001), suppurative type with adjacent necrosis and panniculitis (chi2 = 68.128; p < 0.001), and non-reactive histological types (chi2 = 109.234; p < 0.001) were more commonly seen compared with HIV-seronegative patients. Kikuchi-Fujimoto disease (n = 36), Kimura disease (n = 7), Rosai-Dorfman disease (n = 6), were rare aetiological causes that have been infrequently reported from India.CONCLUSION:
Awareness of the characteristic histopathological findings and uncommon aetiological causes of peripheral lymphadenopathy may spare patients from unnecessary evaluation and treatment. In HIV-positive patients, lymph node tuberculosis may be histopathologically unusual and may be suppurative or non-reactive in nearly one-third of patients.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Lymph Nodes
/
Lymphatic Diseases
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
En
Journal:
Natl Med J India
Journal subject:
MEDICINA
Year:
2007
Document type:
Article
Affiliation country:
India