Painless peripheral lymphadenopathy in Nigerian children

We conducted a diagnostic biopsy during a period of 8 years (January 1981 - December 1988) on 74 consecutive children (aged under 16 years) who attended the University of Calabar Teaching Hospital, Calabar, for chronic enlarged painless lymphadenopathy, with a view to determining the diseases that commonly present with this symptom in our environment. Histological diagnoses returned were predominantly tuberculosis, neoplasms and nonspecific reactive changes. Each of these conditions was evenly distributed among the entire age group. Neoplasms were mainly Hodgkins and non-Hodgkins lymphoma, with Burkitt's tumour the commonest childhood tumour in Nigeria not contributing significantly to the neoplastic lymphadenopathy. Regional enlargement rather than generalised lymphadenopathy seems to be dominant, the commonest sites of involvement being the cervical followed by the inguinal regions. Chronic lymph node enlargement appears to be rare in our environment and only a few disease conditions manifest with peripheral nodes despite the large number of infections and other inflammatory diseases in Nigerian children.