WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Dr. Elaf Wissam Abdul-jabbar* and Asst. Prof. Noora Mustafa Kareem

ABSTRACT

Background: Lymphadenopathy is a pathological process of lymph nodes manifested by abnormally increased size or altered consistency or number. Cervical Lymphadenopathy refers to cervical nodal tissue measuring more than one cm in diameter. It may be classified according to its etiology into reactive and neoplastic. Cervical lymph nodes are a common site of metastases for malignant tumors from other sites; these include upper aerodigestive tract, post nasal and supraclavicular regions. Cervical LAP is further classified into acute (2 weeks duration), subacute (2–6 weeks duration), and chronic (does not resolve by 6 weeks). Objective: To assess the correlation of various clinicopathological parameters of cervical lymphadenopathy with final histopathological diagnosis. Clinicopathological parameters include (Age, Sex, Duration, Clinical presentation, Site, Gross finding, Neoplastic or non-neoplastic diagnosis, Primary neoplasm (lymphoma) vs. secondary (metastatic), histopathological diagnosis. Materials and Methods: A retrospective analysis of 160 randomly chosen patients with cervical lymphadenopathy who were gathered from the Teaching Laboratory of Al Imamain Al-Kadhimain Medical City, the Pathology Departments of Ghazi Al Hariri Surgical Specialties Teaching Hospital, and Teaching laboratories of medical city between January 2024 and December 2024, the samples were collected between January 2018 to December 2023. The slides and histopathology reports for each case were revised and reexamined. The pathology reports of the patients were also used to extract the clinical parameters. Inclusion criteria were patients with cervical lymphadenopathy while samples with insufficient patient data were excluded. Results: The study analyzed the distribution of cervical lymphadenopathy among 160 patients, revealing that the most common age groups were <20 and >50 years, with a mean age of 31 years. Male patients slightly outnumbered females, with a male- to-female ratio of 1.46:1. The most frequent clinical presentation was lymphadenopathy accompanied by systemic symptoms such as fever, weight loss, and night sweats (43.8%), with 78.7% of cases having a chronic duration. Level IV of the cervical lymph nodes demonstrated the highest frequency of lymphadenopathy (22.5%). Most enlarged lymph nodes measured 2–5 cm (66.25%), with 59.4% of cases showing multiple node involvement .Grossly, 53.68% of lymph nodes were discrete, and 62.5% exhibited firm consistency. Reactive lymphadenopathy was the most common cause (35%), followed by tuberculosis. (.5)Among lymphomas, Hodgkin lymphoma accounted for 15% of cases, with mixed cellularity (45.83%) being the most frequent subtype, followed by nodular sclerosis (37.5%). Non-Hodgkin lymphoma represented (.9) of cases, with diffuse large B-cell lymphoma being the predominant subtype (47.4%). Metastatic lymphadenopathy was diagnosed in (17.5%) of cases, with papillary thyroid carcinoma (35.6%) and squamous cell carcinoma of the lung (25%) being the most frequent sources of metastases. Conclusion: Majority of cervical lymphadenopathy in the current study are benign. Reactive follicular hyperplasia is the most commonly observed benign histological finding. Hodgkin lymphoma is the most prevalent form of lymphoma. Mixed cellularity emerged as the most common subtype of HL, followed by nodular sclerosis. Papillary thyroid carcinoma (PTC) was the most common primary malignancy that metastasized to cervical lymph nodes, followed by squamous cell carcinoma.