Title: A Clinico-P Athological Study of Neck Swellings Excluding Thyroid
Authors: Dr S.Jeevaraman, Dr Maragathamani Elangovan, Dr N.Mohammed Niyamathullah
DOI: https://dx.doi.org/10.18535/jmscr/v5i9.21
Abstract
Introduction: “A clinico – pathological study of neck swelling excluding thyroid” is a prospective study of 100 cases. The study was conducted with an objective to know the various etiological factors and clinical factors and clinical presentation of the neck swelling and also to correlate the clinical diagnosis with FNAC and histopathological reports.
Methods: The study was conducted in Thanjavur medical college during study period i.e. from August 2014 to 2016. 100 patients with neck swellings exclusion criteria were included in this study. After a detail history and clinical examination of neck swellings, patient were subjected for FNAC to confirm the diagnosis. Biopsy of the lymph node was performed when FNAC either negative or doubtful to confirm the diagnosis by histopatholo-gical examination. The Age/Sex distribution, clinical presentation, the investigations, the treatment modalities, complications were all evaluated and compared with standard literature.
Results: A total 100 patients were enlisted in this study, tubercular cervical lymphadenitis accounted for 55%. Among them 21 were male patients and 32 females with the female to male ratio being 1.5:1. The commonest group of lymph node region involved was the upper deep jugular group accounting for 70.9% followed by posterior triangle lymph node region accounting for 18.2%. ESR was found to be elevated in all the patients. Sputum AFB was positive in 14 patients (25.5%). FNAC was inconclusive in 4 patients and were subjected for lymph node biopsy. Total of 13 patients underwent lymph node biopsy.
In our study, metastasis in the cervical lymph nodes was the second commonest etiological factor among neck swellings, observed in 13 patient (13%). 11 were diagnosed as having sq. cell carcinoma and 2 as adenocarcinoma metastatic work up revealed the primary site for sq cell ca as tonsilar fossa. posterior pharynx, larynx accounting for 63.6%, 27.3% and 9.1% respectively.6 cases were diagnosed as having lymphoma with the maximum occurrence observed in the age group of 41-60 years. The usual presentation was painless cervical lymphdenopathy.
Other neck swellings observed in our study were cystic hygroma in 4 patients, branchial cyst in 2 patients, and lipoma in 4 patients.
Keywords: Lymph node, Tuberculosis, malignancy, chemotheraphy, excision.
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