Aim:
Description of pathologic causes of cervical lymphadenopathy at Kamuzu
Central Hospital.
Introduction:
The evaluation of cervical lymphadenopathy is a common diagnostic
challenge facing clinicians. Previously at Kamuzu Central Hospital (KCH)
tuberculosis (TB) was reported to be the most common cause of cervical
lymphadenopathy However, no recent study has assessed this common
diagnostic challenge in Malawi, particularly since the beginning of the
HIV epidemic and the subsequent scale-up of antiretroviral therapy.
Methods:
We conducted a cross-sectional study of all cervical lymph node specimens
from the KCH pathology laboratory between 1 July 2011 and 28 February
2013 and describe patient age, gender, and pathologic diagnoses.
Results:
Our search of the KCH pathology database yielded 179 cases. Of these,
143 (77%) were histologic specimens (open biopsy or core needle samples)
while 34 (23%) were cytology specimens. The age range was from 0
to 76 years with a mean of 30 (SD: 19). In adults, the most common
diagnosis was malignancy (n=41, 35%), while in children 15 cases each
of malignancy and benign masses were diagnosed. Only 6 cases (5%) of
TB were diagnosed in adults, and 4 cases (6%) of TB were diagnosed in
children.
Conclusion:
Our study shows more malignancy and much less TB than a prior study
of cervical lymphadenopathy at KCH. With the successful initiaion of
the KCH Pathology Laboratory in 2011, we recommend biopsy or FNA
early in the workup of cervical lymphadenopathy to prevent long delays in
diagnosis and treatment of curable cancers
