Clinico-pathological and radiological profile of peripheral lymphadenopathy in patients with systemic diseases

Abstract

BACKGROUND: Peripheral lymphadenopathy is a physical sign observed in many patients with systemic diseases. In the evaluation of peripheral lymphadenopathy, ultrasonography of the nodes may be used as an adjunct to clinical examination. OBJECTIVE: To evaluate and correlate the clinical and ultra-sonographic profile of peripheral lymphadenopathy in patients with systemic illness with pathological diagnosis. METHODS: Sixty patients (male=30, female=30; mean age=33.38 (SD=14.6) years presenting with systemic illnesses and peripheral lymphadenopathy were included in the study after obtaining approval from Institutional Ethics Committee. A detailed clinical examination of lymph nodes was done, followed by ultrasonography and then sampling of the nodes. On ultrasonography, the nodes were categorized as pathological or reactive and if pathological, an attempt was made to subcategorize into tuberculosis, malignancy and non-specific. The clinical and sonographic features were correlated with pathological diagnosis. Patients with inconclusive pathological diagnosis were followed up for 3 months. RESULTS: Hard consistency and presence of matting were significantly associated with tubercular and malignant pathologies respectively. The sensitivity, specificity and overall accuracy of ultrasonography in diagnosing pathological lymph nodes were 97.3%, 62.5% and 86.8% respectively. Long axis to short axis ratio of <2, abnormal fatty hilum and abnormal vascularity were associated with pathological nodes. CONCLUSIONs: Clinical and sonographic examination of peripheral lymph nodes correlate well with final pathological diagnosis and may guide in deciding the lymph nodes to be sampled.