Diagnostic evaluation of primary cervical adenopathies in a developing country

INTRODUCTION: To review the pathology of lymph node biopsies removed from patients with primary cervical lymphadenopathy. METHODS: A 20 (1987-2006) year retrospective study of all patients who had lymph node biopsy; in the Department of Pathology and Haematology, University of Benin Teaching Hospital, Benin City, Nigeria. RESULTS: Of 357 lymph node biopsies accessioned, 68 (19.0%) cases were in children. Granulomatous diseases constituted 128 (35.9%) cases. Tuberculosis (Tb) was the single commonest cause of cervical lymphadenopathy constituting 125 (35.0%) cases and also the commonest cause of cervical lymphadenopathy below the age of 45 years. Tuberculosis (TB) lymphadenopathy occurred predominantly in male children and young female adults. TB lymphadenopathy was rare above the age of 45 years. Neoplastic diseases constituted 173 (48.5%) cases. Of these, lymphoma predominated comprising 93 (26.1%) cases. These included 37 (10.4%) and 56 (15.7%) cases of Hodgkin?s lymphoma and non Hodgkin?s lymphoma respectively. Hodgkin?s lymphoma occurred most commonly in young male adults. Metastatic tumours constituted 80 (22.4%) cases and was the predominant cause of cervical lymphadenopathy above the age of 45 years. Non specific reactive lymphadenitis constituted 56 (15.7%) cases. CONCLUSION: Chronic lymphadenopathy in our environment has a high incidence of tuberculosis. We recommend urgent lymph node biopsy in significantly enlarged nodes not responding to treatment.