Surgical lymph node biopsies in University of Ilorin Teaching Hospital, Ilorin, Nigeria.

BACKGROUND: To determine the diagnostic value of lymph-node biopsy, commonest causes of lymph node enlargement requiring biopsy and the usual nodes involved.
METHODS: A retrospective study of 169 lymph node biopsies representing 97% of lymph node biopsies and 3.2% of total biopsies specimen received at Pathology Department of University of Ilorin Teaching Hospital Ilorin, Nigeria over a 5 year period was undertaken.
RESULTS: Tuberculous lymphadenitis (38%) and metastatic nodal involvement (25%) were the commonest causes of lymph node enlargement. Generalised lymphadenopathy occurred in 105 (62%) patients while localised enlargement was seen in 64{38%) of cases. The commonest sites of localised lymphadenopathy were axillary (38%), cervical (32%), inguinal (8%), and submandibular (8%). While axillary lymph node enlargements were mostly associated with tumour metastasis, cervical node enlargements were mostly associated with tuberculosis. Supraclavicular lymphadenopathy has the highest risk of malignancy.
CONCLUSION: The result shows that tuberculous lymphadenitis and metastatic nodal malignancies are the commonest causes of lymph node enlargement in our environment. Reasons for this include the often involvement of lymph nodes in tuberculous infections {as lymphadenitis constituted the most frequent form of extra pulmonary tuberculosis} and cancer's metastasis. With an effective and nationwide immunisation against tuberculosis, health education on HIV infection coupled with early screening and detection of malignancies in generals, we hope this trend will change in the future. Lymph node biopsy remains an important and valuable diagnostic tool in evaluation of lymph node enlargement as it allows for the architecture of the gland to be viewed thereby given an accurate and concise diagnosis with very minimal risk to the patient.