Determination of aetiology of superficial enlarged lymph nodes using fine needle aspiration cytology

Abstract

Objective: To asses the causes and patterns of enlarged superficial lymph nodes. Design: Cross sectional survey. Setting: Jimma Teaching Hospital, Pathology Department, Jimma University, southwest Ethiopia for a study conducted between September 1999 and August 2001. Participants: Eight hundred and eight patients presenting with enlarged superficial lymph nodes in cervical, axillary, inguinal etc. regions were included (456 males and 352 females) whereas non lymph node samples and deep-seated lymphoid lesions were excluded from the study. Main outcome measures: Fine needle aspiration cytology (FNAC) technique and wright's staining procedure were utilized to diagnose the causes of enlarged lymph nodes. Results: Of the 1693 patients attended to at the cytologic diagnostic service, 808(47.7%) had lymph node disorders with benign and malignant causes of lymph node enlargements comprising of 93.2% and 6.8% respectively. The most frequent cause of benign enlargement was tuberculous lymph adenities (66.3%), followed by reactive lymph node hyperplasia (19.2%). Among malignant ones, non-hodgkin's lymphomas (2.7%) and metastatic carcinomas (2.2%) were most frequently diagnosed. The cervical region was the most frequent site for enlarged lymph node disorders accounting for more than three quarters of all cases. Conclusion: This study revealed a huge burden of benign lymph node enlargements in general, and tuberculous lymph adenities in particular. The latter was responsible for about two-third of lymph node enlargements in South Western parts of this country. It is recommended that health providers undertake intensive public health education and screening activities in order to help salvage our community from these potentially preventable and treatable causes of enlarged lymph node disorders.