Tuberculous and Toxoplasma Lymphadenitis in Lymph Node Biopsies Received at THP Laboratory from 2011 to 2013

Abstract

Background-Lymph node biopsy is an important investigation which is helpful in coming to a diagnosis when patients present with lymphadenopathy. Tuberculous and Toxoplasma lymphadenitis are frequent findings in lymph node biopsies done in Sri Lanka compared to developed countries as both of these conditions are commoner in developing countries. Therefore we planned to review the lymph node biopsy results from 2011 to 2013 in Teaching hospital Peradeniya with a special interest on clinico-demographic characteristics of tuberculous lymphadenitis and Toxoplasmosis. However histopathological findings can only give a suggestive diagnosis of toxoplasmosis, whilst confirmation needs serological studies. Objectives- To determine the incidences of histopathologically proven tubercuolous and Toxoplasma lymphadenitis and the other commoner pathologies out of the lymph node biopsies done in THP from 1st January 2011 to 31st December 2013 and to identify the clinico-demographic characteristics of the former two conditions. Methods- Lymph node biopsy reports and the request forms from 2011 to 2013 in THP were reviewed. Age, sex, site of lymphadenopathy and the pathological diagnoses were tabulated and analyzed using SPSS. Results- Out of 293 lymph node biopsy reports, 47 (16%) showed tuberculous lymphadenitis, 16 (5.5%) showed toxoplasma lymphadenitis, 75 (25.9%) reactive changes and 54 (18.4%) lymphoma. Metastatic deposits were found in 33 (11.3%). With regard to tuberculous lymphadenitis, females (59.57%) were affected more than males (40.43%). A similar pattern was observed with 63% of those affected being females. In both of these conditions the commonly affected age group was 21-30 years. The most commonly involved group of lymph nodes was cervical (78% of the TB cases and 100% of the cases of toxoplasmosis). The 2nd commonest affected site was axilla. Conclusion- The incidences of both tuberculous lymphadenitis and toxoplasmosis are high. There is a female preponderance in incidence and the 21-30 years age group is commonly affected with cervical lymph nodes being the commonest site. However the commonest pathology affecting lymph nodes is reactive changes in this group.