Mirat Bajwa.
Cervical lymphadenopathy: PIMS experience
J Rawal Med Coll Dec 2004;8(2):78-82.
Pakistan Institute of Medical Sciences, Islamabad

Background: To determine the cause of cervical lymphadenopathy persisting beyond six weeks and comparing the results of diagnostic accuracy of Fine Needle Aspiration Cytology (FNAC) with excision biopsy. Methods: This randomised prospective study was conducted in the Department of Medicine, Pakistan Institute of Medical Sciences (PIMS) from January 99 to April 2000. Fifty patients (27 males and 23 females) aged over 13 years, with cervical lymphadenopathy persisting beyond 6 weeks were included. Thirty four (68%) underwent FNAC while excision biopsy was done in sixteen (32%) cases. Results: Mean age of patients was 27 years. In 32 (94.1%) of FNAC cases, a satisfactory result was obtained while 2 (5.88%) had a hemorrhagic aspirate and reqiured excision biopsy. There were no false positive results with FNAC but 12.5% cases were reported as false positive with excision biopsy. 76% cases had an underlying disease reqiuring treatment. The majority, 32 (64%) had a non malignant cause including tuberculosis (59.3%), reactive hyperplasia (37.5%) and Kikuchi`s disease (3.1%). Malignant cases constituted 36% and included lymphomas (61.1%), metastatic malignancy (27.7%) and acute leukemias (11%). Conclusion: Every case of cervical lymphadenopathy persisting beyond 6 weeks must be investigated and diagnosis confirmed by FNAC as the initial investigation of choice because of its convenience and reliability. Tuberculosis remains the commonest underlying cause followed by malignancies, of which lymphomas are predominant but metastasis also has a significant share.

Category: Surgery
Keywords: Lymphadenopathy. Lymph Nodes. Fine Needle Aspiration Cytology. FNAC.

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