Lymph node pathology in Zimbabwe: a review of 2194 specimens

When the body's defences are breached by infection, information about such an event is channelled through the lymphatic system to the lymphoid organs in which immune responses occur. The key participants in these responses are lymphocytes, which populate the lymph nodes, spleen, and mucosal lymphoid tissues. Together with other cells, they form an architecture and cell network that enables coordinated function. The lymph nodes, which are usually superficial, are easily accessible and therefore frequently sampled by clinicians. The findings on such samples are invaluable in the diagnosis, staging, treatment and prognosis of disease. From the 28,895 histology specimens submitted to the Histopathology unit in Harare, Zimbabwe in the period January 1988 to June 1990, we have selected and reviewed all lymph node biopsy reports. The commonest diseases in the 2194 lymph node specimens submitted were: (a) non specific hyperplasia (33%); (b) tuberculous lymphadenitis (26.7%); (c) metastases (12.4%); (d) Kaposi's sarcoma (9%); (e) lymphomas (7%). The trends for nodal tuberculosis (including hyporeactive tuberculous lymphadenitis), Kaposi's sarcoma, florid follicular hyperplasia and lymphomas are discussed in the context of the increased incidence of HIV-related lymphoadenopathy.