Tuberculous Lymphadenitis in South‑Eastern Nigeria; a 15 Years Histopathologic Review (2000‑2014)

Author(s):

Ukekwe FI*, Olusina DB, Banjo AAF, Akinde OR, Nzegwu MA, Okafor OC and Ocheni S

Background: The human immunodeficiency virus (HIV) pandemic has brought about a resurgence in tuberculosis (TB), especially in developing countries. Previous studies on TB lymphadenitis (TBLN) in SouthâÂ?Â?Eastern Nigeria were done before the advent of the HIV pandemic making a review pertinent. Aim: To evaluate the role of TBLN as a cause of superficial lymphadenopathy in the postâÂ?Â?HIV/acquired immune deficiency syndrome (AIDS) era of SouthâÂ?Â?Eastern Nigeria. Materials and Methods: This is a 15 years (2000–2014) retrospective review of all superficial lymph node biopsies (SLNBs) received at the Department of Morbid Anatomy, University of Nigeria Teaching Hospital, ItukuâÂ?Â?Ozalla Enugu, Nigeria. Results: One hundred and seventyâÂ?Â?two cases of TBLN were identified in this study constituting 14.6% (172/1,180) of SLNBs received at our Hospital’s Morbid Anatomy Department during the 15 years period under review. TwentyâÂ?Â?eight cases of TBLN were clinically screened for HIV, 23 of which tested positive, representing 82.1% (23/28) of clinically screened cases. Acid fast bacilli demonstration was positive in 15.1% (26/172) of cases using ZiehlâÂ?Â?Neelsen stain. 48.8% (84/172) of TBLN cases were males, and 51.2% (88/172) were females with most (22) cases received in 2012 and least (5) cases in 2000. Most TBLN occurred in the 21–25 years age group with a total of 21.5% (37/172) of cases and a male to female ratio of 1:1.5 The most common biopsy site for TBLN was the cervical group followed by the axillary and inguinal groups with 73.8% (127/172), 14% (24/172), and 4.7% (8/172) of cases, respectively. Conclusions: There is a remarkable decline in the prevalence of TB lymphadenitis in SouthâÂ?Â?Eastern Nigeria indicating a change in trend from the preâÂ?Â? to the postâÂ?Â?HIV/AIDS era with slightly more females now presenting with TBLN and most TB lymphadenitis patients now presenting with associated HIV/AIDS disease. There is an urgent need to provide modern diagnostic facilities in our medical laboratories.