A pattern of lymphadenopathies seen in a tertiary care hospital in Lahore, Pakistan

Authors: SOBIA NASEEM, SAIRA BILAL, MAHAM AKHLAQ, NAUSHEEN HENNA, WAQAS SAMI, ABDUL NAGI, MUHAMMAD ASHRAF

Abstract: This cross sectional study was conducted to assess various clinicopathological parameters in 1785 patients from various regions of Punjab. Materials and methods: These cases were collected from Gulab Devi Chest Hospital, Lahore, Pakistan. The data were collected from all patients during a period of 2 years, from June 2006 to June 2008. All the cases were diagnosed after routine hematoxylin and eosin staining. Results: Our observations revealed that the most prevalent lymphadenopathy in these patients was tuberculous lymphadenitis 53% (n = 946), and the most common group of lymph nodes involved is cervical lymph nodes. A significant association was observed between tuberculosis and gender (P < 0.01) as 69.13% (n = 654) of the females presented with tuberculous lymphadenitis that was seen only in 30.86% (n = 292) of the males. Hodgkin's lymphoma was seen in 72 (4.03%) and non-Hodgkin's lymphoma in 27 (1.51%) patients. These lymphomas were seen more in the male patients as compared to the female ones (P < 0.008 and <0.043, respectively). However, in the remaining lymph nodes non-specific inflammatory conditions of the lymph nodes (non-specific lymphadenitis, non-caseating granuloma and reactive hyperplasia), were seen with no difference in the distribution of disease in male or female, P value <0.636, <0.8267, and <0.7507, respectively. A significant association was observed between metastatic lymph nodes and gender P value being <0.01 as 68.70% (n = 90), were males whereas 31.29% (n = 41) were females. Mean age of the patients with tuberculosis was 34 years. On the other hand, both Hodgkin's and non-Hodgkin's lymphomas were seen more prevalent in the second and third decades of their lives. Mixed cellularity and diffuse small cell lymphoma were the commonest histopathological subtypes among Hodgkin's and non-Hodgkin's lymphoma, respectively. Conclusion: Tuberculosis is more common in females (P < 0.01) whereas lymphomas (P < 0.008 in Hodgkin's lymphoma and P < 0.043 in non-Hodgkin's lymphoma) and metastatic carcinoma are more common in males (P < 0.01). The commonly occurring histopathological subtypes of both Hodgkin's (mixed cellularity) and non-Hodgkin's lymphoma (diffuse small cell) in our study differ from those in Western countries.

Keywords: Tuberculous lymphadenopathy, cervical lymphadenopathy, Hodgkin's lymphomas, non-Hodgkin's lymphoma, metastatic carcinomas

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