Cervical lymphadenopathy in Khartoum

In this prospective study, 92 patients with cervical lymphadenopathy presenting at Khartoum Teaching Hospital were studied. The commonest cause was found to be tuberculous cervical lymphadenitis (TCA) comprising 49%, followed by malignancy (35%) including both primary neoplasm (15 cases) and metastatic lesions (17 cases). The tuberculous group were young patients mainly from low socioeconomic classes. The most affected nodes were in the posterior triangle, followed by upper jugular and supraclavicular nodes. In the malignant group, half the patients had primary reticulo-endothelial neoplasm and the other half had metastatic tumours, most often from the nasopharynx. The triad of symptoms of fever, fatigue and loss of weight was found equally in tuberculous and lymphoma patients. Hence empirical use of antituberculous therapy without histological diagnosis resulted in delay in diagnosis of malignancy. Antituberculous therapy should be preceded by histological proof wherever possible.