title: Causes of cervical lymphadenopathy at Kamuzu Central Hospital.
abstract: OBJECTIVE
  Description of pathologic causes of cervical lymphadenopathy at Kamuzu Central Hospital.
  
  
  BACKGROUND
  The evaluation of cervical lymphadenopathy is a common diagnostic challenge facing clinicians. Previously at Kamuzu Central Hospital (KCH) tuberculosis (TB) was reported to be the most common cause of cervical lymphadenopathy However, no recent study has assessed this common diagnostic challenge in Malawi, particularly since the beginning of the HIV epidemic and the subsequent scale-up of antiretroviral therapy.
  
  
  METHODS
  We conducted a cross-sectional study of all cervical lymph node specimens from the KCH pathology laboratory between 1 July 2011 and 28 February 2013 and describe patient age, gender, and pathologic diagnoses.
  
  
  RESULTS
  Our search of the KCH pathology database yielded 179 cases. Of these, 143 (77%) were histologic specimens (open biopsy or core needle samples) while 34 (23%) were cytology specimens. The age range was from 0 to 76 years with a mean of 30 (SD: 19). In adults, the most common diagnosis was malignancy (n=41, 35%), while in children 15 cases each of malignancy and benign masses were diagnosed. Only 6 cases (5%) of TB were diagnosed in adults, and 4 cases (6%) of TB were diagnosed in children.
  
  
  CONCLUSIONS
  Our study shows more malignancy and much less TB than a prior study of cervical lymphadenopathy at KCH. With the successful initiaion of the KCH Pathology Laboratory in 2011, we recommend biopsy or FNA early in the workup of cervical lymphadenopathy to prevent long delays in diagnosis and treatment of curable cancers.
authors: University of Malawi, Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi.
authors: C
authors: C
authors: Mabedi
authors: University of North Carolina, Chapel Hill, USA.
authors: C
authors: C
authors: Kendig
authors: University of Malawi, Kamuzu Central Hospital, Department of Pathology, Lilongwe, Malawi.
authors: G
authors: G
authors: Liomba
authors: University of North Carolina, Chapel Hill, USA ; UNC Project, Lilongwe, Malawi.
authors: C
authors: C
authors: Shores
authors: University of Malawi, Kamuzu Central Hospital, Department of Pathology, Lilongwe, Malawi.
authors: F
authors: F
authors: Chimzimu
authors: University of Malawi, Kamuzu Central Hospital, Department of Pathology, Lilongwe, Malawi.
authors: C
authors: C
authors: Kampani
authors: University of Malawi, Kamuzu Central Hospital, Department of Pathology, Lilongwe, Malawi.
authors: R
authors: R
authors: Krysiak
authors: University of North Carolina, Chapel Hill, USA ; UNC Project, Lilongwe, Malawi.
authors: S
authors: S
authors: Gopal
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008198:Lymph Nodes / Q000473:pathology*; D008206:Lymphatic Diseases / Q000209:etiology / Q000473:pathology*; D008295:Malawi; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D055815:Young Adult