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HISTOLOGIC PATTERNS OF SUPERFICIAL LYMPH NODE DISEASES IN ENUGU, SOUTH-EAST NIGERIA (2000-2009)
Abstract
A ten-year retrospective study of superficial lymph node biopsies received at the Department of
Morbid Anatomy, University of Nigeria Teaching Hospital, Enugu, was done to ascertain the
causes of superficial lymph node diseases in both adults and children, and to determine the
histologic patterns of distribution of superficial lymph node diseases with regards to age, sex,
and site of lymph node biopsy.
A total of 761 superficial lymph node biopsies were received during the ten-year period under
review. This represented 6% of the 12,639 number of total surgical biopsy specimens received
in the department during the above stated period, of which 454 (59.7%) were malignant
superficial lymph node diseases while the remaining 307 (40.3%) were benign superficial lymph
node diseases. Most of these superficial lymph node diseases occurred in the 31-35years age
group.
Metastatic lesions were the commonest cause of superficial lymph node diseases constituting
42.7% of the cases, followed by nonspecific reactive hyperplasia (21.8%), lymphomas (16.7%),
tuberculous lymphadenitis (13.1%) and HIV/AIDS lymphadenopathy (3.3%). Thus, HIV/AIDS
lymphadenopathy was a significant cause of superficial lymph node diseases.
The commonest site of lymph node biopsy for superficial lymph node diseases was the axillary
region with 373 (48.2%) cases followed by cervical region with 267 (34.5%) cases. Most of the
superficial lymph node biopsies were from females with 490 (63.3%) while those from males
were 284 (36.7%) giving a F: M ratio of 1.7: 1.
In adults, metastatic lesions (45.6%), accounted for the commonest cause of superficial
lymphadenopathy, followed by nonspecific reactive hyperplasia (20.3%). Nonspecific reactive
hyperplasia (40%) was the commonest cause of superficial lymphadenopathy in children,
followed by both lymphomas (25%) and tuberculous lymphadenitis (25%).
Lymphomas, accounted for 16.4% of the total lymph node biopsies received, occurring mostly
in males in the 16-20years age group and females in the 26-30years age group. The male and
female cases of lymphoma were mainly of the Hodgkin’s lymphoma type.
Hodgkin’s lymphoma was commoner, 79 (62.2%) than NonHodgkin’s lymphoma 48 (37.8%)
cases, and had a bimodal age presentation with peaks at 16-20years and 66-70years age
groups.
The commonest histological subtype of Hodgkin’s lymphoma was mixed cellularity with a total
28 (35.4%), followed by nodular sclerosis with 22 (27.8%) cases.
NonHodgkin’s lymphoma was commonest in the middle age group of 46-50years and
commoner in males with an overall F: M ratio of 1:2.7. The small lymphocytic type of low grade
NonHodgkin’s lymphoma (29.2%) was the overall commonest followed by the diffuse large cell
type of intermediate grade (22.9%) in our environment.
Nonspecific reactive hyperplasia was the commonest cause of superficial lymphadenopathy in
children, followed by both lymphomas and tuberculous lymphadenitis
The commonest HIV/AIDS associated lymph node disease in our environment was HIV
lymphadenopathy followed by tuberculous lymphadenitis.
In conclusion, the histologic patterns of superficial lymph node diseases in Enugu, South-East
Nigeria have remarkable changed over the last ten years.
