Lymphadenopathy in adults. A clinicopathological analysis

To describe the clinicopathological features of patients admitted to adult wards with a primary presenting feature of lymphadenopathy.

A retrospective study of all patients admitted to Riyadh Medical Complex, Riyadh, Kingdom of Saudi Arabia between April 1996 through to March 2000.

The patients mean age was 35.2 years (standard deviation 15.7 years) and 59.5% were females while 56.2% were Saudis. Swelling was the primary presenting symptom in 39.3% of the patients, while fever, night sweats, and pain occurred in 17.3%, 10.3% and 8.5% patients. There was considerable overlap between benign and malignant causes of lymphadenopathy but in 56.6% of patients, lymphadenopathy was the only sign. The cervical group of lymph nodes was the most commonly affected site. Hepatomegaly, splenomegaly and both organ enlargement occurred in 59 (22.9%) patients. The presence of generalized lymphadenopathy and other physical signs (serositis and organomegaly) highly suggested a malignant process. Granulomatous lymphadenopathy due to tuberculosis was the most frequent pattern 98 (37.9%) followed by lymphoma 85 (32.9%). Tuberculosis was also more common in females than males (51% versus 19%). Among patients with Hodgkin's disease, nodular sclerosis was the most frequent (75%). Routine investigations did not discriminate between benign and malignant causes of lymphadenopathy. The overall mortality rate was 8.1%: with metastatic disease accounting for 52.4%.

There were significant similarities and differences between these findings and other previous studies in the Kingdom of Saudi Arabia and elsewhere.