CERVICAL LYMPHADENOPATHY IN IBADAN, NIGERIA


KO Aramide1, MA Ajani1 and CA Okolo2

  1. Department of Histopathology, Babcock University, Ilishan-Remo, Nigeria.
  2. Department of Pathology, University College Hospital Ibadan, Nigeria.

Abstract

Aim: To determine the pattern and causes of lymph node enlargement of cervical region in Ibadan, Nigeria.

Materials and Methods: A 10-year (2003-2012) retrospective study was conducted on all head and neck lymph node biopsies received at the Department of Pathology, University College Hospital, Ibadan, Nigeria.

Results: A total of 101 lymph node biopsies of cervical region were received within this period of study. 59.4% cases were seen in Males. Second decade of life has the highest number of cases (22.8%) followed by 3rd decade (17.8%). The common cause of cervical lymphadenopathy include non – specific hyperplasia, tumour metastasis and Non Hodgkin’s lymphoma seen in 27 (26.7%), 22 (21.8%) and 20 (19.8%) respectively. Granulomatous and Hodgkin’s Lymphoma constitute 17 (16.8%) and 11 (10.9%) respectively. The granulomatous causes were all due to tuberculosis. A single case of Rosai-Dorfman disease was seen in a male in the 3rd decade of life.

Conclusion: This study shows that metastatic tumours, Hodgkins lymphoma and Non Hodgkins lymphoma constituting 52.4% of all cases of cervical lymphadenopathy are common in this environment therefore highlighting the need for early and proper evaluation of patients.

Keywords: Lymph node, Cervical region, Metastatic, Lymphomas, Ibadan

Correspondence:

Dr. K.O. Aramide
Department of Histopathology,
Babcock University,
Ilishan- Remo,
Ogun State, Nigeria.
E-mail: kolawolearamide@yahoo.com
Tel: +2348033597001

Introduction

Lymphadenopathy is a common clinical finding that may be localized, limited or generalized. The enlargement of a lymph node, due to primary disease or secondary cause, is of concern to both patients and clinicians, particularly, if the underlying pathology is a malignant disease.1 Cervical lymphadenopathy is the commonest form of peripheral lymphadenopathy.2 It has many causes, including benign, infectious and malignant conditions. The evaluation of cervical lymphadenopathy is a common diagnostic challenge facing clinicians.2

Many literature reported that tuberculosis is the most common cause of cervical lymphadenopathy in sub- Saharan Africa, accounting for 17-66% of cases.1-6 However a previous study from University College Hospital, Ibadan by Thomas et al. reported that 37% are due to normal or non-specific reactive changes, 27.7% showed granulomatous inflammation and 35.5% showed malignancy, lymphoid or metastatic tumours.6 Tuberculosis was the single most common granulomatous inflammatory condition constituting 94.5% of the granulomatous inflammatory lesions.6 Tuberculosis was also the commonest cause of lymph node enlargement in childhood (0-14 years) while malignant condition was the commonest above forty-five years of age.6

There are many studies on peripheral lymphadenopathy in Nigeria but not many on cervical lymphadenopathy as an entity which makes having preformed information on likely causes of cervical lymphadenopathy difficult to clinicians.

The aim of this study was to provide a recent update on causes of cervical lymphadenopathy and its common causes in this environment to help clinicians in management of cases of cervical lymphadenopathy