Akmal Jamal, Shahida Khatoon, Afzal Junejo, Bilal Rasool.
Frequency of Hodgkin`s Lymphoma in patient with cervical lymphadenopathy presenting in a public hospital in Pakistan.
J Liaquat Uni Med Health Sci Jan ;7(3):173-6.

OBJECTIVES: To determine the frequency and pattern of presentation of Hodgkin`s lymphoma in cervical lymph node at Liaquat University Hospital, and to see its pathological variants. STUDY DESIGN: Case series. STUDY SETTING: Surgical departments of Liaquat University Hospital. STUDY DURATION: Five years from January 2000 to December 2004. SAMPLING: Non-probable purposive. INCLUSION CRITERIA: All patients of cervical lymph node enlargement of more than four weeks duration irrespective of age and sex. EXCLUSION CRITERIA: Cervical lymph node less than 1cm. STUDY VARIABLES: Study variables used were age, sex, symptom, clinical finding, stage and histopathology. DATA ANALYSIS: Data analysis was done by using SPSS version 10. RESULTS: A total of 500 patients with enlarged cervical lymph nodes were studied, amongst them 40 (8%) patients were diagnosed with Hodgkin`s lymphoma (32 males and 8 females). Mean age of 40 patients was 23 years (range 9-44 years). Out of these 40 patients, in 8 (20%) patients it was difficult to differentiate lymphoma clinically from tuberculosis on clinical examination. Cervical swelling was the commonest symptom (100%) while fever, night sweats and weight-loss were present in 45% patients, 55% of patients were in stage III & IV (advance disease). Mixed cellularity was the commonest histological variant. All 40 patients after diagnosis and staging were referred to Nuclear Institute of Medical Radiotherapy for further management. CONCLUSION: Although tuberculous cervical lymph node enlargement is very common, but Hodgkin`s lymphoma has a definite possibility of occurrence (8% in our study). Therefore all patients with enlarged cervical lymph node should not be treated with anti-tuberculosis therapy on empirical basis. Diagnosis should be confirmed by biopsy, otherwise patients may land up with advanced stage of Hodgkin`s lymphoma with poor prognosis.

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