A perflexing diagnostic and therapeutic dilemma is often presented by enlarged lymph nodes of the head and neck.
For the differential diagnosis of cervical lymphadenopathy when the patient is examined, fine needle aspiration biopsy (FNAB), an office procedure, may furnish immediate definitive diagnosis.
A retrospective study of 580 patients , previously proved cytologicaly and histologically, in Jungang Gil Hospital over a period of 6 yr. (Jan. 1, 1987, to Dec. 31, 1992) was reviewed and analyzed.
Of all 580 cases, most common lesion in adult group was tuberculous lymphadenitis (41.2%) while was non-specific lymphadenitis (91.3%) in child group.
There was a significant difference in the distribution of disease between child and adult group.
In the age and sex distribution, female preponderance was met in tubeculous lymphadenitis (1:3), while male preponderance observed in metastatic cancer (2.1:1) and lymphoma (2.3:1).
Commonly affected age groups were the third decade in tuberculous lymphadenitis, less than second decade in non-specific lymphadenitis and more than fifth decade in metastatic tumor and lymphoma, respectively.
In the site of distribution, suboccipital triangle of posterior neck was most frequently involved in tuberculous lymphadenitis and non-specific lymphadenitis, explained no statistical difference between two age groups. And supraclavicular
triangle
was
important involved site when metastatic cancer was observed. Unilateral location was more common in metastatic cancer than tuberculous or non-specfic lymphadenitis.
Generally, malignant lymphadenopathy with the mean size of 3.3 cm was larger than benign condition. In benign condition, the mean size of lymph node affected by tuberculosis was larger than in non specific lymphadenitis. Especially in
non-specific
lymphadenitis, most patients (75%) were equal or less than 1 cm explaining 98.9% of child patients.
Fine needle aspiration biopsies were performed in 85 cases including 28 cases combining open biopsy and revealed the sensitivity (75%), the specificity (100%) and the accuracy (89.3%), respectively.
Theser results showed FNAB as an easy, safe, rapid and reliable diagnostic procedure.
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