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Introduction: Peripheral lymphadenopathy is frequently due to a local or systemic benign infectious disease. However, it could be a manifestation of underlying malignancy. Fine needle aspiration cytology (FNAC) acting as a reliable diagnostic tool to find out the cause underlying the lymphadenopathy enables the clinician to plan appropriate management for each patient. Objective: The present study was undertaken to assess the utility of FNAC in evaluation of peripheral lymphadenopathy cases in different age groups and sex and to study the cytomorphological patterns in these cases. Materials and Methods: A retrospective and prospective observational study was conducted in the Department of Pathology, Hind Institute of Medical Sciences over the duration of 2 years. A total of 331 lymph node FNA aspirates were studied. Aspirated material was routinely stained with Haematoxylin & Eosin and Papanicolauo stains. Ziehl Neelsen stain was used wherever required. Results: Most of the patients were in the age group of ?15 years (117/331). Cervical lymphnodes were the most commonly involved sites (222/331). The largest group of lesions belonged to the non-neoplastic category (227/331). Only 54/331 cases were in the neoplastic category. Amongst the non-neoplastic lesions, granulomatous lymphadenitis comprised the majority (128/277). Amongst the neoplastic lesions, 8 cases showed features of non-Hodgkin’s lymphoma (NHL); where as 3 cases were of Hodgkin’s lymphoma (HL). Non-neoplastic lesions were more common in the younger age group (117/257); where as neoplastic lesions were more common in the older age group (27/54). Conclusion: FNAC is a reliable method of diagnosing the pathology underlying enlarged superficial lymph nodes; thus acting as a triage to distinguish the cases with a suspicion of significant disease. At the same time, it also provides material for ancillary studies especially in lymphoproliferative lesions. Keywords: FNAC, Cytomorphology, Peripheral lympha

BACKGROUND Lymphadenopathy is one of the commonest presentations in clinical practice. Fine Needle Aspiration Cytology (FNAC) is an established, easy, cost effective, diagnostic tool for lymphadenopathies. Judicious application of FNAC can avoid the need of biopsy. We wanted to compare the accuracy of FNAC and histological analysis of peripheral lymphadenopathy among patients visiting the Departments of Oncology, Pathology, Surgery of K.D. Medical College and determine the most prevalent cause of peripheral lymphadenopathy among different age groups of patients. METHODS This study was done among cases of peripheral lymphadenopathy whose FNAC & biopsy were available. 112 cases of lymph node FNACs were carried out in the Dept. of Pathology for a period of one and half years from July 2018 till December 2019. Special stains were used whenever necessary. RESULTS Out of 112 cases studied 68 cases were male and 44 cases were female. Ratio of M : F = 1.5. The commonest anatomical site for lymphadenopathy was cervical (70 %) followed by supraclavicular (13 %) and axillary (10 %). Coming to the spectrum of the disease 103 cases (91.9 %) were non neoplastic lesions and 9 cases 8.03 % were neoplastic lesions. Reactive hyperplastic was the most common condition 51 cases (45.5 %) followed by tuberculosis 34 cases (30.35 %). Out of cases 9 cases (8.03 %) of malignancy, 5 cases (4.4 %) were metastatic deposits & 4 cases (3.57 %) were lymphomas. The peak age group ranged between 21 - 30 years. Cervical location of distribution of lymphadenopathy is noticed to be highest (70 %), which is then followed by, supra clavicular (13 %), axillary (10 %) and inguinal (5 %). (Maximum number of cases were found in the age group of 21 yr. - 30 yr., least number of cases seen in the age group of 61 yr. – 70 yr. Correlative study between cytopathological &and histopathological examination of lymphadenopathy showed diagnostic discordance in three cases and concordance in 109 cases. CONCLUSIONS Apart from reactive hyperplasia, tuberculosis is the commonest cause of lymphadenopathy & males are commonly affected. FNAC is a safe procedure with high degree of sensitivity and specificity and concordance of 96.64 % with histopathological diagnosis. For confirming the diagnosis of lymph nodes, histopathology is the gold standard. KEYWORDS Lymphadenopathy, FNAC, Histopathology, Biopsy, Tuberculosis

Introduction: Peripheral lymphadenopathy is a common clinical entity. It is significant as the underlying cause could range from a simple infection to a malignant lesion which could be either primary or metastatic. Fine needle aspiration cytology (FNAC) is the first line of investigation usually done to diagnose enlarged lymph nodes. Materials and Methods: This retroprospective study was done in the Department of Pathology, Government Medical College, Haldwani, from January 2008 to December 2018. Relevant details of the patients were taken from the records. The cytological diagnosis and site were noted and divided into major diagnostic categories with respect to age group, sex, and site. Results: A total of 16,985 cases were studied. About 42% showed reactive morphology, 31.77% were tubercular, 23.65% metastatic lesions, 2.49% were hematological malignancies, and only 0.08% were parasitic. The cervical lymph node was the most common site aspirated and it was also the most common site for metastasis (60.45%). Among the metastatic lesions, squamous cell carcinoma accounted for maximum cases (69.10%). Conclusion: FNAC is a simple procedure for investigating enlarged peripheral lymph nodes. The underlying cause may vary depending on the sociodemographic profile of the patients. It is a safe and effective procedure for giving a quick and reliable diagnosis in peripheral lymphadenopathy, thereby avoiding unnecessary excision biopsy.

Today, about 85-95 % of the population is infected with EBV, therefore, the study of the nature of clinical and laboratory changes in patients with chronic EBV infection and the characteristics of the disease is an urgent problem of our time. According to the results of the study, it was found that in patients with chronic EBV infection, chronic tonsillitis, chronic fatigue syndrome and peripheral lymphadenopathy were more often observed among the clinical manifestations. In laboratory studies, it was found that patients with chronic EBV infection are characterized by a significant increase in ESR, an increase in the relative content of lymphocytes and monocytes, as well as a decrease in the absolute and relative content of neutrophils compared with the control group of patients, which indicates the presence of a shift in the leukocyte blood count, characteristic of the disease of viral etiology associated with EBV.

Rosai-Dorfman disease (RDD), also called Sinus histiocytosis is an uncommon proliferative disorder of unknown aetiology. Though, the lymph node is the revelation mode of several diseases particularly in the tropics, RDD typically presents with painless bilateral lymphadenopathy in the neck associated with fever and leukocytosis, sometimes mimics lymphoproliferative disorders. Recently research has unveiled gene mutation in the tumour with potential of malignant transformation. Case report: We report case of 4 year old boy who had massive cervical lymphadenopathy with extranodal manifestation of fever. Sepsis screening was negative, while imaging showed hilar, mediastinal and mesenteric lymph nodes enlargement in addition to massive hepatomegaly. The histology is suggestive of the diagnosis of RDD. The patient was treated with corticosteroids, with remarkable remission. Conclusion: We report the clinicopathological characteristics of RDD in order to increase our awareness of its diagnosis and treatment and to re-emphasize that the disease is rare in our environment

Introduction: Extrapulmonary tuberculosis in form of lymphonodes is the common presentation of tuberculosis in developing countries. Fine needle aspiration cytology helps in early diagnosis & treatment for tubercular lymphadenitis, which remains the cornerstone for the effective management of the disease. Aim: To study the cytological characteristics and compare with the bacteriological load with the help of Zeihl Neelsen stain. Materials and Methods: 445 smears were studied for a period of one year. Smears were categorized into 4 patterns Pattern A - epithelioid cell granulomas without caseous necrosis, Pattern B -epithelioid cell granulomas with caseous necrosis, Pattern C- caseous necrosis without granuloma, Pattern D – neutrophils with abundant caseous necrosis. Bacillary load was graded as 1+, 2+ and 3+ were compared with the cytological categories. A p value of Results: Pattern A was observed in 16.7% cases, Pattern B in 18.3%, Pattern C in 37.8% & Pattern D in 27.2% of cases. Statistical significance was seen between cytomorphological pattern & AFB grade (p=0.026 & X2=20.0639). It was found that pattern C& D showed the highest AFB grade of 3+ by a 2x2 analysis to test the degree of one hypothesis. Conclusion: FNAC is an useful tool in the early diagnosis of tubercular lymphadenitis avoiding the un necessary burden of surgical intervention. Maximum bacillary load was correlated with the patterns C & D. Keywords: Fine needle aspiration cytology, Tuberculosis, Lymph nodes, Caseous necrosis, Acid fast bacilli. Introduction Tuberculosis is a major public health problem worldwide, especially in the developing countries like India. Peripheral lymphadenopathy is the most common manifestation of extrapulmonary tuberculosis.[1],[2]Fine Needle Aspiration Cytology (FNAC) is safe, cost effective and conclusive procedure.[3] It provides an alternative to excision biopsy for lymph nodes and is an easy procedure for collection of

Aim: The aim of this study was to evaluate the paediatric patients with cervical lymphadenopathy (LAP) and to compare the clinical and laboratory features between Epstein-Barr virus (EBV) infections and the other aetiologies. Methods: We conducted a retrospective, single-center study of paediatric patients with cervical LAP from a tertiary care hospital in Turkey between October 2017 and March 2020. The medical records including demographic information, clinical features and laboratory results were collected from paediatric patients with cervical LAP Patients were divided into two groups according to whether the aetiology of LAP was EBV infection or the others. Clinical and laboratory findings were compared between the two groups. Results: A total of 175 patients included in the study. Nonspecific lymphadenitis was the most common diagnosis occurring at a rate of 54.3%. EBV infection was responsible for 17.1% of all causes. The presence of fever, white blood cell (WBC) and lymphocyte count were significantly higher and LAP size was significantly larger in patients with cervical LAP caused by EBV infection. Conclusion: Fever, elevated WBC and lymphocyte count may be predictors for EBV infection in children with cervical LAP. In patients who had these features, serological tests for EBV could make a significant contribution to reach an accurate diagnosis without wasting time.

Background Peripheral lymphadenopathy occurs often in children; fine needle aspiration biopsy (FNAB) is a commonly performed diagnostic procedure. We describe FNAB use and outcome for peripheral lymphadenopathy in children in a routine clinical setting. Methods A retrospective study done at Tygerberg Hospital, Cape Town of children ( Results Of the 173 children, the median age was 37 (interquartile range 13–75) months; 20 (11.5%) were HIV positive. Most FNABs were done in the neck (131; 76%) and axillary areas (34; 20%). FNAB provided a result in 165 (95%) cases; in 8 (5%) children FNAB was insufficient for diagnosis. Mycobacterial aetiology was diagnosed in 84 (49%); 49 (58%) were culture-confirmed (37 Mycobacterium tuberculosis, 10 Mycobacterium bovis BCG, 1 both and 1 non-tuberculous mycobacterium). Reactive lymphadenopathy was diagnosed in 56 (32%), neoplastic disease in 6 (3.5%) and other pathology in 19 (11%) cases. Additional special investigations changed FNAB diagnosis or led to an additional diagnosis in 8 (5%) children. Overall, 70/84 (83%) with mycobacterial aetiology and all neoplastic disease cases received the correct treatment. Follow-up appointments were arranged in 144 (83%) patients. Conclusions In a high tuberculosis burden area, a single FNAB provided a diagnosis in most cases in a routine referral setting; FNAB remains a safe and useful investigation. Follow-up of children to initiate appropriate treatment could improve. LAY SUMMARY Large swollen lymph nodes, especially in the neck, are a common finding in children. Fine needle aspiration biopsy (FNAB) is a commonly used diagnostic procedure and we looked at how well this procedure works in everyday hospital practice. We identified all children 80% of the mycobacterial pathology cases were correctly managed; the latter could definitely improve.

Introduction: Diagnosis of Extra Pulmonary TB (EPTB) remains a challenge. This study assessed the applicability of CB-NAAT in early diagnosis of EPTB, especially peripheral lymphadenopathy and early identification of MDR-TB in TB lymphadenopathy. Material & Method: This was a prospective, cross sectional study, carried out on all patients of age group 10 to 80 years, who were suspected cases of tubercular peripheral lymphadenopathy, visiting the OPD of the Department of Pulmonary Medicine, People’s Hospital, Bhopal, over a period of 1 year 6 months. FNA of peripheral lymph nodes of 57 patients was sent for cytology and CB-NAAT. Result: This study showed that statistical difference in diagnostic yield of FNAC (47/57 i.e. 82.4%) and CB-NAAT (44/57 i.e. 77.19%) in tubercular peripheral lymphnode sample was not significant. This implies that there was not much difference in these two test results. There was no rifampicin resistance in the population studied. Conclusion: CB-NAAT did not diagnose more cases of TB-LN than FNAC.

Following treatment for pneumonia, a 1-y-old female Nubian goat was presented because of a persistent fever for 3 mo and peripheral lymphadenopathy for 1 mo. Cytology and histology of the superficial cervical and prefemoral lymph nodes demonstrated a moderate-to-marked “left-shifted” lymphoid population, suggestive of lymphoma, and extremely rare extracellular, 2–4 µm, oval, basophilic yeast, consistent with Histoplasma capsulatum. On immunohistochemistry, >95% of the lymphocytes demonstrated positive cytoplasmic and membranous immunoreactivity for CD3. Histoplasma spp. urine antigen and serum antibody testing were positive and negative, respectively. Panfungal PCR and sequencing of DNA extracted from scrolls of formalin-fixed, paraffin-embedded tissue yielded matches to H. capsulatum with 99–100% identity. Given the poor prognosis and persistent pyrexia, the animal was euthanized. Postmortem examination confirmed concurrent multicentric, intermediate-size, T-cell, lymphoblastic lymphoma and histoplasmosis; lesions consistent with intestinal coccidiosis and suspected pulmonary Rhodococcus equi were also noted. Although dimorphic fungi have been described previously in goats, lesions of Histoplasma spp. had not been documented in this species, to our knowledge. Given the low disease burden, it is suspected that the lymphoma was primary, leading to an immunocompromised state and development of secondary, opportunistic infections.

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is an uncommon lymphoma that accounts for 3-8% of all Hodgkin lymphomas. NLPHL typically presents as early stage disease with localized peripheral lymphadenopathy. Involvement of extranodal sites at the time of presentation occurs in 6% of cases and most commonly involves the spleen, liver, bone marrow, and Waldeyer ring. Primary extranodal NLPHL is exceedingly rare. We describe the first reported case involving the thyroid and review the six other previously described cases of primary extranodal NLPHL.

Introduction & Objective: Lymphadenopathy in pediatric population is an ever challenging situation. This study was done to study the cytological features of non-neoplastic and neoplastic lesions of enlarged lymph nodes by fine needle aspiration cytology (FNAC) and determine the pattern of diseases affecting the children below 18 years.Materials and Methods: 453 cases between the age group of 0-18 years, referred to the cytology section of the department of Pathology were included in the study over a period of two years. Special stains and biopsy were done in selected cases. Results: Majority of the cases were benign (97.60%), while only 2.4% (13/543 cases) of cases were malignant. Reactive hyperplasia, tuberculous lymphadenitis, suppurative lymphadenitis, metastatic carcinoma and lymphoma were seen in 53.2%, 30.20%, 10.68%, 0.2% and 1.8% respectively. Cervical group of lymph nodes were the most frequently affected nodes. In 37 cases, the cytological diagnosis was compared with histopathological diagnosis.Conclusion: The most frequent cause for lymphadenopathy in pediatric population is reactive hyperplasia followed by tuberculosis.FNAC alone can be useful in establishing diagnosis in large number of cases in proper clinical setting and obviates the need for invasive procedures like surgery. Introduction & Objective: Lymphadenopathy in pediatric population is an ever challenging situation. This study was done to study the cytological features of non-neoplastic and neoplastic lesions of enlarged lymph nodes by fine needle aspiration cytology (FNAC) and determine the pattern of diseases affecting the children below 18 years. Materials and Methods: 453 cases between the age group of 0-18 years, referred to the cytology section of the department of Pathology were included in the study over a period of two years. Special stains and biopsy were done in selected cases. Results: Majority of the cases were benign (97.60%), while only 2.4% (13/543 cases) of cases were malignant. Reactive hyperplasia, tuberculous lymphadenitis, suppurative lymphadenitis, metastatic carcinoma and lymphoma were seen in 53.2%, 30.20%, 10.68%, 0.2% and 1.8% respectively. Cervical group of lymph nodes were the most frequently affected nodes. In 37 cases, the cytological diagnosis was compared with histopathological diagnosis. Conclusion: The most frequent cause for lymphadenopathy in pediatric population is reactive hyperplasia followed by tuberculosis.FNAC alone can be useful in establishing diagnosis in large number of cases in proper clinical setting and obviates the need for invasive procedures like surgery. Normal 0 false false false EN-IN X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;}

Introduction: As components of peripheral or secondary lymphoid organs, lymph nodes are an important part of immune system. Their enlargement is noted in a wide spectrum of diseases, including infections and malignancy, they are a common finding in clinical practice. Therefore, peripheral lymphadenopathy is common in all age groups and management of cases depends on lymph node pathology, which can be studied by collecting material through fine-needle aspiration or excision biopsy. Objectives: The study was undertaken to assess the cytomorphological features and incidence of various lymph node diseases on fine-needle aspiration cytology (FNAC) and to analyze the utility and diagnostic importance of FNAC in lymph node diseases. Materials and Methods: In the study total of 187 patients were selected who had presented with lymph node enlargement at Department of Pathology in our Tertiary Care Centre. Results: Reactive lymphoid lesions comprised the majority (33.69%) followed by tubercular lymphadenitis, metastatic malignancies, acute suppurative lymphadenitis, and lymphomas, respectively. Conclusion: Reactive lymphoid and tubercular lesions were the most common among the lymph node swellings presentations. FNAC is a simple, safe, reliable, and inexpensive method in early detection of lymph node lesions, which has been proven once again in this study.

Introduction: The causes of superficial lymphadenopathy are diverse and their prognosis is often unknown. The diagnosis of superficial lymphadenopathy remains a challenge because, alone, its clinical picture doesn’t allow differentiating between an infec...

Follicular lymphoma is the second most common subtype of non-Hodgkin's lymphoma affecting adults. Clinically, follicular lymphoma is generally indolent, most often presenting as a painless peripheral lymphadenopathy; however, a leucocytosis at presentation is exceedingly rare. We present the case of a 63-year-old woman with follicular lymphoma with a presenting hyperleucocytosis at diagnosis of 1 327 000/μL demonstrated on laboratory analysis work while hospitalised for progressive weakness. fluorescence in situ hybridization (FISH) panel was consistent with follicular lymphoma, which was positive for B-cell leukaemia/lymphoma 2 and negative for MYC Proto-Oncogene. Cytoreduction with rituximab-containing therapy was initiated, with the patient ultimately expiring. A leukaemic phase at presentation appears to be associated with poor outcome. The findings from our case, in addition to others, have potential implications in regard to prognostic utility. The current prognostic tool used to estimate overall survival for follicular lymphoma, Follicular Lymphoma International Prognostic Index, does not take leucocytosis into account.

La tuberculosis extrapulmonar representa el 1520 % de todas las formas de presentación. La tuberculosis ganglionar periférica es la segunda forma extrapulmonar más frecuente en niños de Argentina, luego de la pleural. En el Servicio de Tisiología del Hospital de Niños "Dr. Ricardo Gutiérrez", se analizaron en forma retrospectiva 92 casos de tuberculosis ganglionar periférica asistidos entre agosto, 2000-septiembre, 2015. La edad media fue 8,7 ± 5 años. Las adenopatías fueron periféricas únicas (31,5 %), periféricas múltiples (20,6 %) y periféricas asociadas a profundas (47,8 %). Predominó la localización cervical (80 %). El 80 % recibió antibioticoterapia previa, sin respuesta. El 56 % tenía foco de contagio conocido; 69 %, prueba cutánea de tuberculina positiva y 54 %, radiografía de tórax patológica. Todos iniciaron tratamiento antifímico por clínica compatible, exposición y/o prueba cutánea de tuberculina positiva, antes de la confirmación microbiológica o histológica. La evolución fue curación (81,5 %), derivación cercana al domicilio (8,7 %), abandono (8,7 %). Un paciente falleció. Extrapulmonary tuberculosis accounts for 15-20 % of all clinical presentations of tuberculosis. Peripheral tuberculous lymphadenitis is the second most common presentation of extrapulmonary tuberculosis in children, after pleural tuberculosis, in Argentina. We analyzed 92 patients with peripheral tuberculous lymphadenitis seen at the Department of Tisiology of Hospital de Niños "Dr. Ricardo Gutiérrez" between August 2000 and September 2015. The patients' mean age was 8.7 ± 5 years. Nodal sites corresponded to single peripheral (31.5 %), multiple peripheral (20.6 %), and peripheral associated with deep nodes (47.8 %). Cervical lymph nodes were the most common site of involvement (80 %). In 80 % of patients previous antibiotic therapy had been administered, without response. The tuberculosis source was known in 56 %; 69 % had a positive tuberculin skin test; and 54 %, a pathological chest X-ray. Tuberculosis treatment was started on all patients based on clinical criteria, exposure and/or positive tuberculin skin test, prior to microbiological or histological confirmation. The clinical course was either healing (81.5 %), referral to a facility near home (8.7 %) or dropout (8.7 %). One patient died.

Objective. To study the patient profile for symptomatic peripheral lymphadenopathy in terms of histopathological findings and demography and evaluate the yield, relevance, and outcomes of peripheral lymph node biopsy (PLNB) as a diagnostic step in a remote setup in the absence of less invasive options like fine-needle aspiration cytology (FNAC) or ultrasonogram- (USG-) guided FNAC.Methods. A retrospective review of patients undergoing PLNB between 1 May 2011 and 30 April 2013 was done. Demographics, histopathological reports, and outcomes were studied.Results. Of 132 patients, 51 (38.63%) were male and 81 (61.36%) were female. There were 48 (36.3%) patients in the age group less than 16 years, and 84 (63.6%) were beyond 16 years. The commonest site of biopsy was the neck in 114 (86.36%) patients. The histopathological diagnosis was tuberculosis (TB) in 60 (45.45%) patients, reactive lymphadenitis in 29 (21.9%), nonspecific granuloma in 18 (13.6%), lymphoma in 7 (5.3%), acute lymphadenitis in 7 (5.3%), metastatic secondary in 3 (2.2%), and other benign causes in 8 (6.06%).Conclusions. PLNB is a procedure with good diagnostic yield in evaluation of peripheral lymphadenopathy. Its relevance is appreciable in a remote setup where less invasive options are unavailable. Its simplicity and lack of mortality/significant morbidity make it a valid option in rural surgical practice.

Background. Although Burkitt lymphoma (BL) is the most common childhood lymphoma in sub-Saharan Africa, Hodgkin lymphoma (HL) and other non-Hodgkin lymphomas occur. Diagnosing non-jaw mass presentations is challenging with limited pathology resources. Procedure. We retrospectively analyzed 114 pediatric lymphomas in Lilongwe, Malawi, from December 2011 to June 2013 and compared clinical versus pathology-based diagnoses over two time periods. Access to pathology resources became more consistent in 2013 compared with 2011-2012; pathology interpretations were based on morphology only. Results. Median age was 8.4 years (2.1-16.3). The most common anatomical sites of presentation were palpable abdominal mass 51%, peripheral lymphadenopathy 35%, and jaw mass 34%. There were 51% jaw masses among clinical diagnoses versus 11% in the pathology-based group ( P < .01), whereas 62% of pathology diagnoses involved peripheral lymphadenopathy versus 16% in the clinical group ( P < .01). The breakdown of clinical diagnoses included BL 85%, lymphoblastic lymphoma (LBL) 9%, HL 4%, and diffuse large B-cell lymphoma (DLBCL) 1%, whereas pathology-based diagnoses included HL 38%, BL 36%, LBL 15%, and DLBCL 11% ( P < .01). Lymphoma diagnosis was pathology confirmed in 19/66 patients (29%) in 2011-2012 and 28/48 (60%) in 2013 ( P < .01). The percentage of non-BL diagnoses was consistent across time periods (35%); however, 14/23 (61%) non-BL diagnoses were pathology confirmed in 2011-2012 versus 16/17 (94%) in 2013. Conclusions. Lymphomas other than Burkitt accounted for 35% of childhood lymphoma diagnoses. Over-reliance on clinical diagnosis for BL was a limitation, but confidence in non-BL diagnoses improved with time as pathology confirmation became standard. Increased awareness of non-BL lymphomas in equatorial Africa is warranted.

Background and aims Lymphadenopathy, which is defined as an abnormality in the size or character of lymph nodes, is caused by the invasion or propagation of either inflammatory cells or neoplastic cells into the node. It results from a vast array of disease processes. Lymphadenopathy in children commonly arises from benign etiologies. A thorough history usually points the clinician in this direction A common finding in the primary care outpatient setting, lymphadenopathy is typically explained by identifiable regional injury or infection. Among the serious illnesses that can present with lymphadenopathy, perhaps the most concerning to the patient and physician alike is the possibility of underlying malignancy. Methods I have studied a number of 58 cases diagnosed with peripheral lymphadenopathy hospitalised for a period of 4 years. For each case we considered age, sex, nutritional status, family history of contact with patient tuberculed, status of BCG The cases were diagnosed with fine needle aspiration cytology or by histopathology. Results We found the causes involved in peripheral lymphadenopathy was represented by reactive, tumoral, infectious and tuberculous pathology. The most important pathology was infectious and tuberculous pathology. The most frequent case was in the age interval 0–3 years and we found also a male predominence. Conclusions Lymphadenopathy is a sign of a variety of underlying disorders, most of which are benign in children. Less commonly, there is a more serious cause of lymphadenopathy and thus it is extremely important to think of and rule out malignancy through a thorough history and physical exam.

Background: Although peripheral lymphadenopathy is a common presentation in Red Sea State, Sudan, no previous work was made to assess its causes. So, this study is done to identify the underlying causes of peripheral lymph nodes enlargement in the adult patients. Place and Duration of Study: Red Sea Medical Center laboratory, Port Sudan, Sudan between November 2006 and June 2010. Methods: Three hundred twenty seven patients presented with lymphadenopathy were examined by FNAC and histopathological techniques. The sites and the causes of the enlarged lymph nodes were identified. Clinical data were collected in predesigned questionnaires. Results: Generalized lymphadenopathy was found in 25 patients (7.7%). The vast majority of the patients (69.4%) had cervical lymph node enlargement. The commonest cause of lymphadenopathy was tuberculosis (39.5%), followed by metastatic diseases (24.7%). Non Hodgkin’s and Hodgkin’s lymphoma represent 16.6% of the patients. Metastatic tumors commonly present after the age of 50 years (92.6%). Females are more affected by TB than males (60.1%). In this study, 180 of the cases were females and 147 cases were males. Conclusions: FNAC and in some cases lymph node biopsy should be done to any adult patient with chronic peripheral lymphadenopathy in the studied area. This will assist in the early diagnosis and proper management of the patients.

Background: Lymphadenopathy is an age old affliction of mankind and a very common presentation in clinical practice. The main purpose of an FNA biopsy of abnormal peripheral lymph nodes is to determine whether further surgical excision of the lymph node is indicated for histopathological examination. The aim of the present study was to evaluate the role of fine needle aspiration cytology in patients with superficial lymphadenopathy and to correlate with histopathology wherever possible.Methods: A two-year study was undertaken at the Central Diagnostic Laboratory at A.J. Institute of Medical Sciences, Mangalore. Patients of all age groups referred to the Central Diagnostic Laboratory for FNA of superficial lymph nodes were included in the study. All the slides of the cases were reviewed and impression recorded.Results: Out of 200 cases, 73% were non neoplastic, 27% were neoplastic. Cases occurred most commonly in age group of 21-30 years. The male to female ratio was 1.7:1 and most common site of lymph node aspiration was cervical lymph node in (n =107) 53.5% cases. Reactive hyperplasia was the most common non- neoplastic cause of lymphadenopathy seen in 34.5% cases and metastasis to lymph node was the most common cause of neoplastic lymphadenopathy seen in 22% of the cases. The sensitivity was 90%, specificity was 100% and accuracy was 96.2%.Conclusions: FNA is a very efficient, simple, safe, inexpensive and economical test for detecting the various causes of lymphadenopathy.

Castleman disease is a rare lymphoproliferative disorder with two distinctive presentations, namely Unicentric disease and Multicentric disease. Unicentric disease occurs as a solitary enlarged mass in the mediastinum and is rarely found in the head and the neck, whereas, Multicentric disease appears as a systemic disease with peripheral lymphadenopathy. Here we discuss an unusual case with characteristic clinical, radiologic and histologic findings of a 22-year-old male with Unicentric disease demonstrating a slow growing neck mass often times misdiagnosed as a lymphoma.

Primary gastric lymphoma accounts for less than 5% of gastric cancers. They are usually non-Hodgkin’slymphomas (NHL), but have been considered as a separate entity from NHLs of peripheral nodes. The diagnosis of primary lymphoma of stomach requires histological confirmation without any evidence of peripheral lymphadenopathy or organomegaly. Secondary gastric lymphoma indicates the involvement of the stomach by a diffuse lymphoma developed elsewhere. Here we report a 50 year old male presented with abdominal pain and intermittent vomiting and diagnosed as primary gastric lymphoma.J MEDICINE July 2015; 16 (2) : 132-134

Castleman disease is a rare lymphoproliferative disorder with two primary subtypes that vary in presentation and course. Unicentric Castleman disease (UCD) presents as a solitary mass, most commonly in the mediastinum, and rarely in the head and neck. In contrast to multicentric Castleman disease (MCD), which features peripheral lymphadenopathy and numerous systemic symptoms, UCD is not typically associated with generalized symptoms. Here, we present an unusual case of UCD presenting as a slowly expanding, isolated neck mass in a 29-year-old woman. This case demonstrates the distinguishing clinical, radiologic, and histologic findings unique to UCD, which is often misdiagnosed as lymphoma or other malignant process. These findings stand in contrast to those observed in MCD patients, and hence, offer insight into the practical aspects of diagnosis and management of Castleman disease in the head and neck.

Objective: To compare the results of Fine Needle Aspiration Cytology (FNAC) with open biopsy in cases of Peripheral Lymphadenopathy. Design: A comparative study. Place and duration of study: Department of Paediatric Surgery & Department of Pathology, Nishtar Medical College & Hospital, Multan from January 2004 to September 2004. Subjects and methods: Patients presenting with Peripheral Lymphadenopathy in Paediatric Surgery out patient department were included in study. Relevant history and clinical findings were entered in performa and patients were submitted to investigations like FNAC and open lymphnode biopsy, after getting consent, on OPD basis. Results: Results of both FNAC and histopathology in 54 patients were available for comparison at the end of study. FNAC showed tuberculosis in 36 (66.67%), lymphoproliferative process in 16 (29.63%) and poor yield in 2 (3.71%) cases. Whereas open lymphnode biopsy on histopathology confirmed tuberculosis in 42 (77.78%), Hodgkin`s lymphoma in 4.(7.42%), Non Hodgkin`s in 6 (11.13%) and reactive hyperplasia in 2 (3.71%) cases. Sensitivity of FNAC in tuberculosis was 85.7% with a specificity of 100% in cases of tuberculosis while it was 71.5% in cases of lymphomatous process with an overall sensitivity of 78.5% in peripheral lymphadenopathy. Conclusion: In our setup lymphnode biopsy should be performed in all suspected cases to avoid long term morbidity and mortality especially in clinically malignant illnesses.

INTRODUCTION: peripheral lymphadenopathy is a common clinical presentation in Nigeria, and there have been many studies published on it from different parts of the country. This study is to provide an update on the clinicopathological pattern of lymphadenopathy in Ibadan. METHODS: lymph node biopsies received at the Department of Pathology, University College Hospital, Ibadan, Nigeria from January st 2003 to December 31st 2012 were reviewed. Special stains and immunohistochemistry were also applied. RESULTS: 429 cases,251 females and 178 in males were studied. Modal age group was in the sixth decade. The mean age of females (41.4 years) was significantly greater than that of males (34.5 years), p=0.000. Commonest sites were axillary (31.5%) and neck groups (24%), with axillary nodes more often involved in females and neck group of nodes more often involved in males. Metastatic cancer and reactive hyperplasia were the commonest diseases. Males more frequently had non-specific hyperplasia (34.3%) and non-Hodgkin lymphoma (23.6%), while females more often had metastasis (45.4%) and non-specific hyperplasia (19.1%). Patients with metastatic cancer had the highest mean age of 46.5 years, followed by those with malignant lymphomas and reactive hyperplasia. CONCLUSION: primary and metastatic malignancies are common causes of lymphadenopathy in this environment. The use of selective immunohistochemical antibody panels is advocated for proper diagnosis of malignant lesions of the lymph node.