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Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67]
www.ijrpp.com
~ 60~
ISSN Print: 2278 – 2648 IJRPP |Vol 3 | Issue 1 | Jan-Mar-2014
ISSN Online: 2278-2656 Journal Home page: www.ijrpp.com
Research article Open Access
Cervical lymph Node Enlargement
N.Junior Sundresh*1
, S.Narendran2
.
1
Reader in surgery, Department of surgery, RMMCH, Annamalai university, Chidambaram,
T.N., India.
2
Emerutus Prof. of surgery, Department of surgery, RMMCH, Annamalai university,
Chidambaram, T.N., India.
* Corresponding author: N.JuniorSundresh,
E-mail id: juniorsundresh@yahoo.com
ABSTRACT
Cervical lymph nodes are enlarged in almost all neck and head pathologies. Tuberculosis was the major cause for
cervical lymphadenopathy. Pathological examination was also mandatory. Lymph node enlargement is seen in
almost all disease and may be due localized pathology or a part of generalized disease. The cervical lymph nodes is
more common and may be due to a head and neck disease or a manifestation from a distant organ because of this,
clinical investigations like biopsy and details about the lymphatic drainage of the area are the main perquisites for a
correct diagnosis.
Key Words: Cervical lymph nodes, cervical lymphadenitis, cervical lymphadenopathy.
INTRODUCTION
Lymph node enlargement is seen in almost all disease
and may be due localized pathology or a part of
generalized disease.1-6
The cervical lymph nodes is
more common and may be due to a head and neck
disease or a manifestation from a distant organ
because of this, clinical investigations like biopsy and
details about the lymphatic drainage of the area are
the main perquisites for a correct diagnosis. 7-11
MATERIALS AND METHODS
This study was conducted during august 2011 – July
2013 in 70 patients with cervical lymph node
enlargement are selected. The patients with age 13
and above, cervical lymphadenitis patients who were
not responding to antibiotic treatment were induced
in the study. the patients with any one or combination
of following symptoms swelling in the neck, pain,
pyrexia, sinus with discharge, chronic cough,
generalized weakness, headed scar, dyspnoea,
dysphasia, loss of weight appetite and any other
swelling are included general clinical examination
was also made.12-18
OBSERVATION AND RESULTS
The study is based on 70 patients with cervical
lymphadenopathy. Cervical lymphadenopathy most
commonly occurred below 40 years and tuberculosis
International Journal of Research in
Pharmacology & Pharmacotherapeutics
Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67]
www.ijrpp.com
~ 61~
is the most common cause of cervical lymphadenitis.
Tuberculosis affect more commonly the females in
the study. It is found that Tuberculosis cervical
lymphadenitis is commonly affects the younger and
middle age group. Hodgkins’ disease cervical
lymphadentis affect more commonly the females.
Non-hodgbin’s lymphoma affect more commonly the
male secondaries affect more commonly the male and
also affect more commonly the middle age group.
Upper cervical lymphnode is more commonly
involved. Non-specific lymphadenitis affect more
commonly the male and affect more commonly the
younger age group.
Table 1.Sex wise incidence
Sex No. of Patients affected %
Male 32 45.7 %
Female 38 54.3 %
Total No. of cases = 70
Fig 1. Sex wise incidence
Table 2. Age wise incidence of cervical lymphadenopathy
Age group No. of Patients affected %
13 – 22 20 28.5 %
23 – 32 18 25.7 %
33 – 42 20 28.5 %
43 – 52 5 6.25 %
53 and above 7 8.75 %
32
38
No. of Patients affected
Male
Female
Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67]
www.ijrpp.com
~ 62~
Fig 2. Age wise incidence of cervical lymphadenopathy
Table 3. Disease wise incidence of cervical lymphadopahty
Disease No. of Patients affected %
Tuberculosis 41 58.5
Hodgkin’s disease 2 2.85
Non-Hodgkin’s disease 1 1.42
Secondary’s 8 11.4
Non-specific lymphadentis 18 24
Fig 3. Disease wise incidence of cervical lymphadopahty
0
5
10
15
20
25
13 – 22 23 – 32 33 – 42 43 – 52 53 and
above
Age wise incidence of cervical
lymphadenopathy
No. of Patients affected
41
2
1
8
0
Disease wise incidence of cervical
lymphadopahty
Tuberculosis
Hodgkin’s disease
Non-Hodgkin’s disease
Secondary’s
Non-specific lymphadentis
Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67]
www.ijrpp.com
~ 63~
Table 4. Sex wise incidence of tuberculosis
Sex No. of Patients affected %
Male 15 36.5 %
Female 26 63.5 %
Total No. of cases = 41
Fig 4. Sex wise incidence of tuberculosis
Total No. of cases = 41
Table 5. Age wise distribution of tuberculosis
Age group No. of Patients affected %
13 – 22 13 31%
23 – 32 12 29.26%
33 – 42 12 29.26%
43 – 52 3 7.31%
53 and above 1 2.43%
Total No. of cases = 41
15
26
Sex wise incidence of tuberculosis
total
Male
Female
Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67]
www.ijrpp.com
~ 64~
Fig 5. Age wise distribution of tuberculosis
Total No. of cases = 41
Table 6. Lymph node groups involved in tuberculosis
Lymphnode group No. of Patients affected %
Submandibular 1 2.43%
Upper cervical 27 65.8
Middle cervical 1 2.43%
Power cervical 9 21.9
Posterior cervical 2 4.8
Multiple nodes 1 2.43%
No. of cases = 41
Fig 6. Lymph node groups involved in tuberculosis
1
27
1
9
2 1 Lymphnode group
Submandibular
Upper cervical
Middle cervical
Power cervical
Posterior cervical
Multiple nodes
0
5
10
15
13 – 22 23 – 32 33 – 42 43 – 52 53 and
above
Age wise distribution of
tuberculosis
No. of Patients
affected
Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67]
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Table 7. Sex wise incidence of tuberculosis total
Sex No. of Patients affected %
Male 1 3.33 %
Female 2 66.66 %
No. of cases 3
Fig 7. Sex wise incidence of tuberculosis total
Table 7.Sex wise incidence in non Hodgkin’s lymphoma
Sex No. of cases %
Male 1 100 %
Female 0 -
No. of cases 1
Table 8.Age wise incidence in secondaries
Age No. of Patients affected %
13 – 22 0 -
23 – 32 1 12.56 %
33 – 42 2 25 %
43 – 52 1 12.56 %
53 and above 4 50 %
Total No. of cases = 8
Sex wise incidence of tuberculosis
total
Male
Female
Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67]
www.ijrpp.com
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Table 9.Sex wise incidence in non-specific lymphadentis
Total No. of cases = 18
Table 9. Age wise incidence in non-specific lymphadentis
Age No. of Patients affected %
13 – 22 8 44.44%
23 – 32 4 22.22%
33 – 42 4 22.22%
43 – 52 1 5.55%
53 and above 1 5.55%
Total No. of cases = 18
CONCLUSION
Out of 70 patients, women were found to he affected
more than men and tuberculosis was the commitment
cause of cervical lymphadenopathy Tuberculosis was
found to be the common causative factor in age group
below 22 years and secondary’s was common in 50-
60 age group. Also revealed that histopathological
examination is mandatory in accurate diagnosis of
cervical lymphadenitis.
REFERENCE
[1] Rothenberg sm, ellisen lw (2012) the molecular pathogenesis of head and necksquamous cell carcinoma. J clin
invest 122: 1951-1957.
[2] Mokhtari s (2012) mechanisms of cyst formation in metastatic lymph nodes of head and neck squamous cell
carcinoma. Diagnpathol 7: 6.
[3] Hoang jk, vanka j, ludwig bj, glastonbury cm (2013) evaluation of cervical lymph nodes in head and neck cancer
with ct and mri: tips, traps, and a systematic approach. Ajr am j roentgenol 200: w17-25.
[4] Ferlito a, robbins kt, shah jp, medina je, silver ce, et al. (2011) proposal for a rational classification of neck
dissections. Head neck 33: 445-450.
[5] Sureshkannan p, vijayprabhu, john r (2011) role of ultrasound in detection of metastatic neck nodes in patients
with oral cancer. Indian j dent res 22: 419-423.
[6] Saafan me, elguindy as, abdel–aziz mf, abdel-rahmanyounes a, albirmawy oa, et al. (2013) assessment of
cervical lymph nodes in squamous cell carcinoma of the head and neck. Surgery curr res 3: 145.
Doi:10.4172/2161-1076.1000145
[7] Ackerman. L. V.; surgical pathology, 5th edition, c.v. Mosby and co. 726, 1974.
[8] Acta cytology, 1992 may.
[9] Aroka v.k.and ramesli vakma: india j. Tuberculosis, 38, 79-80,1991.
[10]American journal of pathology 1992. April.
[11] BAJLEYandlove's:shortpracticeof surgery,22nd
kdn,h.k.lewis and co., ltd., 1990.
[12]Beathnach c.s.: british journal of tuberculosis and disease ofchest, 330-4, 1958.
[13] Bullex andannpollack i anicncanjournalofclinicalpathology, 23-1953.
[14] B.m.j.: 1902 jul. 18: 305 (6846) : 173-6.
Sex No. of cases %
Male 10 55.55
Female 8 44.45
Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67]
www.ijrpp.com
~ 67~
[15] Cancer immunology and immunotherapy, 1991, 34 (3)
[16]Cervicac lymphadenitis:researchcommittoftuberculosis association of india, ind. J. Tub 1987. 34, 96-
100.
[17]Charles rob and rodney smith: clinical surgery, 9ih
edn.butterworths, 1964.
[18]Chaubec.k. Etal: ind. J. Tub. 37, 98-96, 1990.
[19]Dandapath m.c. Et al: ind. J. Tub. 34, 1 39-, 42, j 987.
[20]Das.s. : a manual on clinical surgery. 9rd
edn. 2011
[21]Dass.: a practical guide to operative surgery.2011

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Cervical lymph node enlargement

  • 1. Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67] www.ijrpp.com ~ 60~ ISSN Print: 2278 – 2648 IJRPP |Vol 3 | Issue 1 | Jan-Mar-2014 ISSN Online: 2278-2656 Journal Home page: www.ijrpp.com Research article Open Access Cervical lymph Node Enlargement N.Junior Sundresh*1 , S.Narendran2 . 1 Reader in surgery, Department of surgery, RMMCH, Annamalai university, Chidambaram, T.N., India. 2 Emerutus Prof. of surgery, Department of surgery, RMMCH, Annamalai university, Chidambaram, T.N., India. * Corresponding author: N.JuniorSundresh, E-mail id: juniorsundresh@yahoo.com ABSTRACT Cervical lymph nodes are enlarged in almost all neck and head pathologies. Tuberculosis was the major cause for cervical lymphadenopathy. Pathological examination was also mandatory. Lymph node enlargement is seen in almost all disease and may be due localized pathology or a part of generalized disease. The cervical lymph nodes is more common and may be due to a head and neck disease or a manifestation from a distant organ because of this, clinical investigations like biopsy and details about the lymphatic drainage of the area are the main perquisites for a correct diagnosis. Key Words: Cervical lymph nodes, cervical lymphadenitis, cervical lymphadenopathy. INTRODUCTION Lymph node enlargement is seen in almost all disease and may be due localized pathology or a part of generalized disease.1-6 The cervical lymph nodes is more common and may be due to a head and neck disease or a manifestation from a distant organ because of this, clinical investigations like biopsy and details about the lymphatic drainage of the area are the main perquisites for a correct diagnosis. 7-11 MATERIALS AND METHODS This study was conducted during august 2011 – July 2013 in 70 patients with cervical lymph node enlargement are selected. The patients with age 13 and above, cervical lymphadenitis patients who were not responding to antibiotic treatment were induced in the study. the patients with any one or combination of following symptoms swelling in the neck, pain, pyrexia, sinus with discharge, chronic cough, generalized weakness, headed scar, dyspnoea, dysphasia, loss of weight appetite and any other swelling are included general clinical examination was also made.12-18 OBSERVATION AND RESULTS The study is based on 70 patients with cervical lymphadenopathy. Cervical lymphadenopathy most commonly occurred below 40 years and tuberculosis International Journal of Research in Pharmacology & Pharmacotherapeutics
  • 2. Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67] www.ijrpp.com ~ 61~ is the most common cause of cervical lymphadenitis. Tuberculosis affect more commonly the females in the study. It is found that Tuberculosis cervical lymphadenitis is commonly affects the younger and middle age group. Hodgkins’ disease cervical lymphadentis affect more commonly the females. Non-hodgbin’s lymphoma affect more commonly the male secondaries affect more commonly the male and also affect more commonly the middle age group. Upper cervical lymphnode is more commonly involved. Non-specific lymphadenitis affect more commonly the male and affect more commonly the younger age group. Table 1.Sex wise incidence Sex No. of Patients affected % Male 32 45.7 % Female 38 54.3 % Total No. of cases = 70 Fig 1. Sex wise incidence Table 2. Age wise incidence of cervical lymphadenopathy Age group No. of Patients affected % 13 – 22 20 28.5 % 23 – 32 18 25.7 % 33 – 42 20 28.5 % 43 – 52 5 6.25 % 53 and above 7 8.75 % 32 38 No. of Patients affected Male Female
  • 3. Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67] www.ijrpp.com ~ 62~ Fig 2. Age wise incidence of cervical lymphadenopathy Table 3. Disease wise incidence of cervical lymphadopahty Disease No. of Patients affected % Tuberculosis 41 58.5 Hodgkin’s disease 2 2.85 Non-Hodgkin’s disease 1 1.42 Secondary’s 8 11.4 Non-specific lymphadentis 18 24 Fig 3. Disease wise incidence of cervical lymphadopahty 0 5 10 15 20 25 13 – 22 23 – 32 33 – 42 43 – 52 53 and above Age wise incidence of cervical lymphadenopathy No. of Patients affected 41 2 1 8 0 Disease wise incidence of cervical lymphadopahty Tuberculosis Hodgkin’s disease Non-Hodgkin’s disease Secondary’s Non-specific lymphadentis
  • 4. Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67] www.ijrpp.com ~ 63~ Table 4. Sex wise incidence of tuberculosis Sex No. of Patients affected % Male 15 36.5 % Female 26 63.5 % Total No. of cases = 41 Fig 4. Sex wise incidence of tuberculosis Total No. of cases = 41 Table 5. Age wise distribution of tuberculosis Age group No. of Patients affected % 13 – 22 13 31% 23 – 32 12 29.26% 33 – 42 12 29.26% 43 – 52 3 7.31% 53 and above 1 2.43% Total No. of cases = 41 15 26 Sex wise incidence of tuberculosis total Male Female
  • 5. Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67] www.ijrpp.com ~ 64~ Fig 5. Age wise distribution of tuberculosis Total No. of cases = 41 Table 6. Lymph node groups involved in tuberculosis Lymphnode group No. of Patients affected % Submandibular 1 2.43% Upper cervical 27 65.8 Middle cervical 1 2.43% Power cervical 9 21.9 Posterior cervical 2 4.8 Multiple nodes 1 2.43% No. of cases = 41 Fig 6. Lymph node groups involved in tuberculosis 1 27 1 9 2 1 Lymphnode group Submandibular Upper cervical Middle cervical Power cervical Posterior cervical Multiple nodes 0 5 10 15 13 – 22 23 – 32 33 – 42 43 – 52 53 and above Age wise distribution of tuberculosis No. of Patients affected
  • 6. Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67] www.ijrpp.com ~ 65~ Table 7. Sex wise incidence of tuberculosis total Sex No. of Patients affected % Male 1 3.33 % Female 2 66.66 % No. of cases 3 Fig 7. Sex wise incidence of tuberculosis total Table 7.Sex wise incidence in non Hodgkin’s lymphoma Sex No. of cases % Male 1 100 % Female 0 - No. of cases 1 Table 8.Age wise incidence in secondaries Age No. of Patients affected % 13 – 22 0 - 23 – 32 1 12.56 % 33 – 42 2 25 % 43 – 52 1 12.56 % 53 and above 4 50 % Total No. of cases = 8 Sex wise incidence of tuberculosis total Male Female
  • 7. Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67] www.ijrpp.com ~ 66~ Table 9.Sex wise incidence in non-specific lymphadentis Total No. of cases = 18 Table 9. Age wise incidence in non-specific lymphadentis Age No. of Patients affected % 13 – 22 8 44.44% 23 – 32 4 22.22% 33 – 42 4 22.22% 43 – 52 1 5.55% 53 and above 1 5.55% Total No. of cases = 18 CONCLUSION Out of 70 patients, women were found to he affected more than men and tuberculosis was the commitment cause of cervical lymphadenopathy Tuberculosis was found to be the common causative factor in age group below 22 years and secondary’s was common in 50- 60 age group. Also revealed that histopathological examination is mandatory in accurate diagnosis of cervical lymphadenitis. REFERENCE [1] Rothenberg sm, ellisen lw (2012) the molecular pathogenesis of head and necksquamous cell carcinoma. J clin invest 122: 1951-1957. [2] Mokhtari s (2012) mechanisms of cyst formation in metastatic lymph nodes of head and neck squamous cell carcinoma. Diagnpathol 7: 6. [3] Hoang jk, vanka j, ludwig bj, glastonbury cm (2013) evaluation of cervical lymph nodes in head and neck cancer with ct and mri: tips, traps, and a systematic approach. Ajr am j roentgenol 200: w17-25. [4] Ferlito a, robbins kt, shah jp, medina je, silver ce, et al. (2011) proposal for a rational classification of neck dissections. Head neck 33: 445-450. [5] Sureshkannan p, vijayprabhu, john r (2011) role of ultrasound in detection of metastatic neck nodes in patients with oral cancer. Indian j dent res 22: 419-423. [6] Saafan me, elguindy as, abdel–aziz mf, abdel-rahmanyounes a, albirmawy oa, et al. (2013) assessment of cervical lymph nodes in squamous cell carcinoma of the head and neck. Surgery curr res 3: 145. Doi:10.4172/2161-1076.1000145 [7] Ackerman. L. V.; surgical pathology, 5th edition, c.v. Mosby and co. 726, 1974. [8] Acta cytology, 1992 may. [9] Aroka v.k.and ramesli vakma: india j. Tuberculosis, 38, 79-80,1991. [10]American journal of pathology 1992. April. [11] BAJLEYandlove's:shortpracticeof surgery,22nd kdn,h.k.lewis and co., ltd., 1990. [12]Beathnach c.s.: british journal of tuberculosis and disease ofchest, 330-4, 1958. [13] Bullex andannpollack i anicncanjournalofclinicalpathology, 23-1953. [14] B.m.j.: 1902 jul. 18: 305 (6846) : 173-6. Sex No. of cases % Male 10 55.55 Female 8 44.45
  • 8. Junior Sundresh et al / Int. J. of Res. in Pharmacology & Pharmacotherapeutics Vol-3(1) 2014 [60-67] www.ijrpp.com ~ 67~ [15] Cancer immunology and immunotherapy, 1991, 34 (3) [16]Cervicac lymphadenitis:researchcommittoftuberculosis association of india, ind. J. Tub 1987. 34, 96- 100. [17]Charles rob and rodney smith: clinical surgery, 9ih edn.butterworths, 1964. [18]Chaubec.k. Etal: ind. J. Tub. 37, 98-96, 1990. [19]Dandapath m.c. Et al: ind. J. Tub. 34, 1 39-, 42, j 987. [20]Das.s. : a manual on clinical surgery. 9rd edn. 2011 [21]Dass.: a practical guide to operative surgery.2011