Aetiology of adult peripheral lymphadenopathy in King Khalid hospital,
Majmaah city, KSA
The lymph nodes are peripheral lymphoid organs and along with spleen,
tonsils and mucosa-associated lymphoid tissue play a central role in the
control of immune response. Normal lymph nodes are small (less than 1
cm) and rounded structures. They are populated by many cell types (
lymphocytes, plasma cells, macrophages,….) and connected to the
circulation by afferent and efferent lymphatics and postcapillary venules.
There are over 500 lymph nodes gathered in a variety of groupings
throughout the body (cervical, supra- and infraclavicular, axillary, …). The
term lymphadenopathy is used to describe abnormality in size, number
or consistency of lymph nodes, caused by invasion or propagation of
either inflammatory cells or neoplastic cells into the node.
Lymphadenopathy results from a variety of diseases such as infections
(tuberculosis,…), malignancies (lymphoma,…), autoimmune disorders
(rheumatoid arthritis,…), storage diseases (Gaucher`s, …) and
miscellaneous (sarcoidosis,…). It either localized (involving single group)
or generalized (involving more than one group). The peripheral
lymphadenopathy is a common clinical presentation and physical
examination finding, however it offers an important diagnostic clue to
the underlying disease. In some cases the diagnosis and management of
peripheral lymphadenopathy is made on the basis of careful history and
physical examination, in other cases the diagnosis and management
cannot be made on the basis of history and examination alone but
require more diagnostic and confirmatory investigations (fine needle
aspiration, true-cut biopsy, excisional biopsy,…).
Research Problem and motivation:
Palpable peripheral lymphadenopathy is an important clue to the
underlying disease. However the cause of peripheral lymphadenopathy
often cannot be identified on clinical ground alone. Furthermore the
therapeutic and prognostic implications of peripheral lymphadenopathy
require an accurate diagnosis. Excisional biopsy of the most accessible
lymph node provides material to establish an early and accurate
diagnosis and is important in the management of the patient. In the
histopathology laboratory of King Khalid hospital excisional biopsies of
enlarged lymph node are routinely received and processed. They are
used commonly to reach and to confirm diagnosis and also to rule out
any superimposed pathological condition. Despite the large number of
received and reported cases of peripheral lymphadenopathy there is
paucity of information on the spectrum of diseases affecting lymph
nodes in this region, little is known about the aetiology, is it mostly
caused by malignancies or infections or other cause, if it caused by
malignancy what is the commonest type and also there is no
documentation about the distribution of this condition among the
population is it more common in male or female and in which age group
it more common so that many questions need answers. However in this
study we are going retrospectively to analyze case records of received
and processed in histopathology laboratory of lymph nodes excisional
biopsies with the aim to answer questions mentioned in previous
paragraph, define and rule out the causes of peripheral
lymphadenopathy also determine their distribution among adult
population in this region and correlate the results with the international
studies.
Material and method:
All cases of lymph node excisional biopsies received and processed at
histopathology laboratory King Khalid hospital, Majmaah city, KSA from
January 2010 until December 2014 will be reviewed. The cases in adult
15 years of age and above will form the focus of this retrospective study.
The specimens received from patients below the age of 15 years will be
excluded. The patients data regarding age, sex, anatomical site and
clinical information will be obtained from request forms and case
records.
Objectives:
1234-
To review cases of lymph node excisional biopsies
To determine the aetiology of peripheral lymphadenopathy
To identify the commonest causes of peripheral lymphadenopathy
To recognize the distribution of lymphadenopathy among adult
age
5- To recognize the distribution of lymphadenopathy among sex
6- To correlate the results with international studies