Indian Journal of Pathology and Oncology


Histopathology and immunohistochemistry of lymph node biopsies: A prospective study from a tertiary care hospital in Kashmir


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Article Type : Research Article

Author Details: Samina Ali Khanday,Ruby Reshi,Majid Mushtaque*

Volume : 6

Issue : 3

Online ISSN : 2394-6792

Print ISSN : 2394-6784

Article First Page : 400

Article End Page : 405


Abstract

Objective: To determine the histopathological spectrum of lymphadenopathy by evaluation of the biopsy specimen and relevant immunohistochemistry of accessible lymph nodes.
Materials and Methods: A total of 196 cases of lymph node biopsies were analysed. En bloc lymph node dissection in known cases of primary malignancy or associated with evidence of primaries elsewhere in the body are excluded from the study.
Results: A total of 196 cases of lymph node biopsies analysed included 102(52.04%) males and 94(47.96%) females. The mean age for males was 35.2 + 19.9 years and that for females was 36.4 + 19.7 years. Maximum numbers of cases were seen in the age group 11-30 years (76 cases, 38.76%). The most common site for nodal biopsy was cervical (60.2%), followed by axillary (18.9%), and inguinal (7.1%). Cervical region was the commonest site (15.72% males and 14.9% females) of biopsy in the age group 11-20 years. Benign lesions (52.1%), were more common than Malignancies (47.9%). The most common benign diagnosis was Reactive LAP in 77(39.3%), followed by tubercular lymphadenitis accounting for 24 cases (12.2%).
Among the malignancies, lymphomas were predominating accounting for 85 (43.3%) cases. Among the lymphomas, non-Hodgkin lymphomas (NHLs) were more common accounting for 63 (32.2%) than the Hodgkin’s disease (HD) which constituted 22 (11.2%) of lymphadenopathies with mixed cellularity as the commonest form. Metastases from unknown primary were seen in 9 (4.6%) cases of palpable enlarged peripheral nodes. Among the patients with reactive LAP, the commonest age group involved was 21-30 years in males and 11-20 years in females, while that for NHL (DLBCL) it was 41-50 years and 51-60 years respectively. Tuberculosis was most commonly seen in the age group of 21-30 years in both sexes. Hodgkin’s disease was common in age group >61 years and metastasis in 31-40 years age group.
Conclusion: In our study among the biopsied nodes, lymphomas were the most common (43.3%) followed by reactive LAP (39.3%), tuberculous lymphadenitis (12.2%) and metastasis (4.6%). Lymph node biopsy is gold standard investigation in establishing the cause of lymphadenopathy. Though lymphomas can be confidently diagnosed on morphology, application of monoclonal antibodies and identification of immunophenotypic profile has enhanced diagnostic accuracy and has prognostic implications.

Keywords: Lymph node, Biopsy, Immunohistochemistry.

Doi :-https://doi.org/10.18231/j.ijpo.2019.077