PATTERN OF CERVICAL LYMPHADENOPATHY AMONG PATIENTS ATTENDING ENT CLINICS IN AL MUTHANNA PROVINCE. A CROSS-SECTIONAL STUDY AT AL-HUSSEIN TEACHING HOSPITAL, SAMAWA, IRAQ (2020–2022)
DOI:
https://doi.org/10.5281/zenodo.23360550Keywords:
cervical lymphadenopathy; lymph node; ENT; Iraq; tuberculosis; lymphoma; neck swelling; reactive lymphadenitis; metastatic carcinoma; Al-Hussein Teaching HospitalAbstract
Background: Cervical lymphadenopathy is a commonplace case seen in the clinical practice of Otolaryngology. With both blood-borne and malignant causes of disease prevalent in each geographic region, as well as variable access to health care, the prevalence of this clinical problem is highly variable around the world. Current data regarding cervical lymphadenopathy in Iraq, particularly from Al-Muthanna Governorate, is limited, necessitating local institutional studies to develop local treatment.
Objective: The aim of this study was to determine the distribution and types of cervical lymphadenopathy and to develop clinicopathologic features of cervical lymphadenopathy patients who presented to the ENT Clinic at Al-Hussein Teaching Hospital in Samawa, Iraq, between January 2020 and December 2022.
Methods: This study was a prospective cross-sectional study of 320 patients with cervical lymphadenopathy. Each study participant underwent full clinical evaluations, haematological evaluation, imaging assessment, and histopathologic assessment if indicated. Clinical characteristics collected included age, sex, size, location, consistency, and clinical diagnosis by physicians.
Results: There were 320 patients with an average age of 31.4 (± 14.7) years (range 3 – 78). Woman represented 54.1% of study patients. The most common cause of cervical lymphadenopathy was reactive lymphadenopathy (38.4% of all patients) followed by tuberculous lymphadenitis (22.8%), lymphoma (14.1%), metastatic carcinoma (11.9%), infectious mononucleosis (6.6%) and all other causes (6.3%). Level II was the most common site of lymphadenopathy involvement (41.6%). The frequency of malignant causes of cervical lymphadenopathy increased significantly in patients older than 40 years of age (p < 0.001).
Conclusion: In this region, reactive lymphadenopathy and tuberculous lymphadenitis are the most frequent causes of cervical lymphadenopathy. However, a sizable portion of patients with cervical lymphadenopathy have a malignant cause, therefore confirming the importance of a systematic approach to evaluation including histopathologic evaluation. Clinicians operating in resource-limited areas should have a high index of suspicion for tuberculosis and malignancy in patients with cervical lymphadenopathy.
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