European Journal of Cardiovascular Medicine

Research Article Open Access

A Follow up Study of Tuberculous Cervical Lymphadenopathy and Evaluation of Causes of Non Resolving

Pages 179 - 185

Abstract

Background: Tuberculosis is a major public health issue worldwide. Tuberculous lymphadenopathy is the most common kind of extrapulmonary tuberculosis (EPTB), accounting for 35% of all EPTB cases. Methods: This observational study was carried with the aim of the present study was to study the various clinical presentation of Tuberculous cervical Lymphadenopathy. A pre structured proforma was used to collect base line data, detailed history with clinical examination was done

Research Article Open Access

Clinico Pathological Profile of Significant Cervical Lymphadenopathy in Paediatric Age Group

Pages 1129 - 1134

Abstract

Background: Lymph node enlargement is a normal age related physiological change, may also herald chronic infections and serious conditions like autoimmune disorders. Etiology varies from region to region. However few studies have emphasized on the clinico- pathological correlation. Material and Methods: This is a Prospective study in a tertiary care hospital setting. Seventy consecutive children reporting to the Department of Pediatrics, Dr. VRK Women College, Hyderabad, Telangana were studied. FNAC, Mantoux test and hematological parameters were performed in all the cases. Additional investigations like culture, serological test and roentgenogram were done wherever required. Results: Among 70 cases the common age group was 4year to 8 years in 41.4% children .The etiology was confirmed in 84.3% cases and could not be ascertained in 21.4 % cases even after relevant investigations. Cytological examination revealed reactive lymphadenitis in 74.3% cases, tubercular lymphadenitis in 14.3% cases and Suppurative lymphadenitis in 7.1% cases, 4.3% cases yielded inadequate aspirate . Commonest etiology diagnosed after detailed investigation was due to infections in areas of drainage like tonsils, ear and scalp, oral cavity in 38.5% cases followed by tuberculosis in 24.2% cases. In addition, there were 12.8% cases of HIV , 2.9% cases were measles . Sensitivity of FNAC in TB was 58.9%. Conclusion: Reactive lymphadenitis due to underlying infection caused by streptococcal and staphylococcal infections were the commonest treatable entity of significant pediatric cervical lymphadenopathy. Further studies and longer follow-up involving detection of antigen and antibodies against lesser known viruses, parasites and rarer causes of lymphadenopathy may decrease the fraction of undiagnosed reactive conditions .

Research Article Open Access

Efficacy of Ultrasonography in the Diagnosis of Extra Pulmonary Tuberculosis

Pages 559 - 562

Abstract

Background: India, like many other developing nations has seen a steady decline in pulmonary tuberculosis over the past decades due to successful implementation of RNTCP-DOTS programme nationwide and improvement in social & economic condition of the general population. It is now seen that extra-pulmonary presentations form a major proportion of new cases. A majority of them present as head and neck tuberculosis (TB) - tubercular cervical lymphadenopathy. In spite of advent of newer diagnostic tools like nuclear ploidy, genetic analysis, nuclear scan and so on, Ultrasonography (USG) being the simplest, quickest and non-invasive diagnostic modality with high sensitivity has gained a very significant place in clenching early diagnosis of neck nodes. Aims & Objectives To calculate the Sensitivity, Specificity & Predictive Accuracy of USG in diagnosis of Extra Pulmonary Tuberculosis (EPTB) when presenting as cervical lymphadenopathy. Material &Methods A prospective, cross sectional study was conducted for 12 months in a Medical College and Hospital among the patients attending the ENT, Surgery, Paediatrics and Medicine OPD & IPD with cervical lymphadenopathy. After estimating the sample size,172 patients were included in this study. After obtaining approval from the IEC and informed consent of the participants, they were selected according to the inclusion and exclusion criteria. Result The Sensitivity and Specificity of USG in reference to TB cervical lymphadenopathy were 91.43% and 84.38% respectively with a positive predictive value of 96.24% and negative predictive value of 69.23%. 15.63% were false positive and false negative were 08.57%. Conclusion USG is an effective, non-invasive, inexpensive and safe tool with a high Sensitivity which can become an important and integral screening modality in the diagnosis of Extra Pulmonary Tuberculosis.

Research Article Open Access

Value of Ultrasonography in Evaluation of Cervical Lymphadenopathy with Cytological Correlation

Pages 1061 - 1066

Abstract

Introduction: Lymphadenopathy is defined as an abnormality in the size or character of the lymph node. It is caused by invasion or propagation of either inflammatory cells or neoplastic cells into the node. Cervical lymphadenopathy may be the sole clinical finding or may coexist with other non-specific findings and recognition of enlarged cervical lymphnodes will often unveil a spectrum of differential diagnosis. Aims: To evaluate sonographic features in cervical lymphadenopathy under different parameters, distribution of etiologies according to sonological parameters and sensitivity and specificity of different sonographic parameters in differentiating benign from malignant lymphadenopathy. Materials and Methods: The present study was an observational study with prospective component. This study was conducted for 18 months at department of Radiology, Murshidabad Medical College and Hospital, Berhampore, West Bengal. Result: In the present study among malignant nodes 44% showed peripheral vascularity and 56% showed mixed pattern of vascularity. Echogenic hilum showed 89% and 77% sensitivity and specificity in differentiating malignant nodes with PPV and NPV of 44% and 97% respectively.. Conclusion: Different sonographic parameters have high sensitivity and specificity in differentiating malignant from benign nodes

Research Article Open Access

Study of Cervical Lymphadenitis in Central India Population

Pages 917 - 926

Abstract

Background: Tuberculosis is a specific infectious disease caused by bacteria belonging to the "Mycobacterium tuberculosis complex". It presents a great social and economic problem and is one of the major factors responsible for high morbidity and mortality in India. The incidence of tuberculous cervical lymphadenopathy accounts for two third of extra pulmonary tuberculous lymphadenopathy. Higher proportion of tuberculous origin is because of greater incidence of pulmonary tuberculosis in our country. Perhaps there are many other causes of lymphadenopathy which are usually misdiagnosed as tuberculosis. Thus, it has been a common problem for both the clinicians as well as the pathologists to diagnose tuberculosis. Methods and Materials: The present work is carried out in 100 clinically suspected cases of tuberculous cervical lymphadenitis attending E.N.T., Surgery, Paediatrics and Medicine Department of central India institute as an outdoor/indoor patient during the period of one year. Patients with enlarged cervical lymph nodes with a history suggestive of tuberculosis were included after taking an informed consent. Results: Study was conducted on 100 clinically suspected cases of tuberculous cervical lymphadenitis, Tuberculosis was diagnosed in 57% cases by FNAC, smear and culture together, the maximum incidence of tuberculosis was observed in second and third decades, Females were more affected (64%) than males with the ratio of 1:2.3. FNAC showed accuracy of 42%, 30% cases were AFB smear positive in our study which nearly matches to other authors. The culture studies could diagnose 57 cases as tuberculous and 4 cases as non-tuberculous cervical lymphadenitis. Culture positive was higher in granulomatous necrotic lesions. Sensitivity, specificity and predictive values of culture study were significantly higher than FNAC and smear. These methods of investigation require considerable experience and confidence of the pathologist who perform the procedure for better results. When culture was taken as Gold Standard, cytology was found to be more sensitive than smear. Conclusions: From this study we concluded that Both FNAC and smear are quick, simple, less traumatic and cost-effective methods and are used as routine investigating procedures in OPDs of urban and semi-urban hospitals. Simplicity of these techniques (FNAC & Smear) combined with early availability of results and good diagnostic accuracy warrants their clinical application. Missed cytological diagnosis and isolation of non-tuberculous mycobacteria justify the use of culture studies in all suspected tuberculous lymphadenitis cases.

Research Article Open Access

Clinicopathological Profile of Significant Cervical Lymphadenopathy in Paediatric Age Group ( 1month to 12 years)

Pages 36 - 37

Abstract

Background- Cervical Lymphadenopathy is a common problem in children and it is considered significant if the diameter exceeds 1 cm for cervical and 1.5 cm for axillary lymph node. Common pathology is infective and mostly benign and self limiting.

Objective- To study the clinicopathological profile of significant cervical lymphadenopathy in age group 1 month to 12 year

Methodology- This is a prospective observational study of 75 patients with significant cervical lymphadenopathy. This study was conducted at Department Of Paediatrics & Neonatology, RIMS, Ranchi, Jharkhand from April 2018 to March 2019. History, clinical examination, Mantoux test, Hemogram, Fine Needle Aspiration Cytology (FNAC) were performed in maximum cases. USG and CT were done in some cases.

Result- Out of 75 cases, cervical lymphadenopathy was maximum in 4 to 8 years (42.7%), 8 to 12 years (36%), and least in 1 month to 4 years (21.3%). Neck swelling (89.3%), fever (90.7%), cough (50.7%), loss of weight (26.7%), and ear discharge ( 10.7%). Most common site of cervical lymphadenopathy was cervical and least was in occipital. Lymph node consistency was firm ( 89.4%), soft (93%) and rubbery (1.3%). Associated findings were tonsillitis and/or pharyngitis, hepatosplenomegaly.

Conclusion- Lymphadenopathy is a sign of many underlying disorders and mostly benign. Few are serious which should be ruled out through examination . FNAC should be done in doubtful cases. Reactive Lymphadenitis due to bacterial or viral pathogens were the most common cause.

Research Article Open Access

A Clinico- epidemiological study of cervical lymphadenopathy at a tertiary care hospital

Ratla N. Bharat singh naik,

A. Setu Madhavi,

Shravan Medikonda,

Ede Naresh Babu,

Thokala Sivaiah

Pages 534 - 542

Abstract

Background: The enlargement of Cervical lymph nodes is quite significant in that there are so many etiological agents and is an index spread of infections, malignancy, autoimmune disorders, and some other miscellaneous conditions etc. is very much difficult to diagnosis. So the purpose of our study is to systematically identify the many pathogenic conditions presenting with enlarged lymph nodes in the neck, as well as the scenario of different ways of presentation of these disorders both clinically and pathologically with the help of FNAC and Ultrasonography diagnostic techniques there by better management services could be rendered to the affected individuals in our set up. Research Question: What is the scenario of different ways of presentation of cervical lymphadenopathy both clinically and pathologically in our set up? The setting of the study was at department of General Surgery, Government General Hospital, Government Medical College, Machilipatnam, Andhra Pradesh. A one year observational study was conduct during the period from October 2022 to September 2023 on about 60 Cervical lymphadenopathy cases visited General Surgery OPD during the above period by studying their socio-demographic profiles, histopathological examination of Lymphadenopathy, distribution of presenting complaint, distribution of primary cancerous site with neck secondaries and treatment & outcome of the study subjects etc. Results: It was observed that the majority about 35% of cases were belongs to the age group 41-50 years followed by 23.5% between 21-30 years, 16.6% between both 31-40 years & 51years and above and 8.5% between 12-20 years of age group with the mean age was 58.3 years. And regarding the sex males were more in number significantly when compared to females that was 1.7:1. Regarding histopathological diagnosis and categorisation, majority of the cases were Tuberculosis lymphadenopathy (43.5%) followed by Secondaries (28.3%) Reactive lymphadenopathy (23.3%), Hodgkin´s lymphoma (3.3%) and Non-Hodgkin´s lymphoma (1.6%). Related to distribution of presenting complaint almost all the cases were visited the hospital with the complaint h/o neck swelling and among the other symptoms fever was the common one (33.3%) followed by cough (30%), decreased appetite (26.6%), weight loss, pain (20%), painful swallowing (3.3%) and voice change (1.6%). With reference to Primary cancerous sites with neck secondaries, Oral cavity occupies major position (23.5%) followed by Larinx (11.7%), Stomach (11.7%), Esophagus (5.8%) and Thyroid (5.8%) respectively and regarding histopathology Squamous cell carcinoma was the commonest one observed. The overall recovery rate was 65% and the complete recovery (100%) was observed among Tubercular cervical lymphadenitis and Reactive lymphadenitis and the maximum number of cases missed for the followup was observed in Secondaries neck and mortality was observed in Secondaries neck and Hodgkin`s lymphoma.

Research Article Open Access

Clinico-Pathological Spectrum of Differentiated Thyroid Carcinomas: A One-Year Cross-Sectional Analysis at A Tertiary Surgical Centre in India

Sigilipelli Venkata Ramana,

Ravichandra Matchal,

Yesu Prasad

Pages 57 - 61

Abstract

Background: Differentiated thyroid carcinomas (DTCs), encompassing papillary and follicular subtypes, constitute the majority of thyroid malignancies and present significant diagnostic and therapeutic challenges. With increasing global incidence, region-specific data are vital to optimize management protocols. This study aims to delineate the demographic distribution, histological patterns, clinical presentations, and surgical outcomes of DTCs in a tertiary care setting. Materials and Methods This cross-sectional observational study was conducted over a one-year period in the Department of Surgery, Andhra Medical College. Fifty-seven patients with histologically confirmed differentiated thyroid carcinomas were included. Data on demographics, clinical presentation, diagnostic workup, operative interventions, and post-operative complications were collected and analyzed descriptively. Results Of 57 patients, 44 (77.2%) were female and 13 (22.8%) male, with a mean age of 43.6 ± 13.2 years. Papillary thyroid carcinoma was the predominant subtype (82.5%), followed by follicular carcinoma (14%) and Hurthle cell carcinoma (3.5%). The most common presenting complaint was anterior neck swelling (100%), with 35.1% of cases presenting with cervical lymphadenopathy. Total thyroidectomy was performed in 63.2% of patients. Postoperative hypocalcemia (26.3%) and transient recurrent laryngeal nerve palsy (7%) were the most frequent complications. Conclusion PTC remains the commonest subtype of thyroid carcinoma, with a marked female preponderance. Early detection, accurate histopathological classification, and tailored surgical intervention remain cornerstones of effective management. The study findings reinforce the importance of comprehensive preoperative evaluation and long-term follow-up in differentiated thyroid cancers.

European Journal of Cardiovascular Medicine

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