Diagnostic Spectrum of Cervical Lymph Node Biopsy: A Retrospective Study from a Tertiary Cancer Centre in South India

Abstract

Background: Cervical lymphadenopathy is common, and its causes range from benign infection to malignancy. Fine-needle aspiration cytology (FNAC) is usually the first investigation, but when the yield is poor or nodal architecture is required, tissue biopsy becomes necessary.

Objective: To describe the histopathological spectrum of cervical lymph node biopsies at a tertiary cancer centre in South India and to assess the diagnostic yield and safety of the procedure.

Methods: We retrospectively reviewed the records of all patients who underwent cervical lymph node biopsy over a 2-year period. Demographic characteristics, preoperative imaging findings, biopsy technique, nodal level, type of anaesthesia, histopathological diagnosis, and postoperative complications were recorded and analysed descriptively.

Results: Seventy patients were studied (mean age 55.1 ± 18.5 years; 54.3% male). Excision biopsy was used in 91.4% and wedge biopsy in 8.6%, and malignancy was suspected clinically in 90% before biopsy. PET-CT was performed in 77.1%, and level V was the node most often sampled (35.7%). Malignancy was confirmed in 40 patients (57.1%) and benign disease in 30 (42.9%). Benign disease was led by tuberculosis (n = 11) and reactive hyperplasia (n = 9). Among the malignant diagnoses, lymphoma was the commonest (n = 14), followed by metastatic carcinoma from the lung, head and neck, thyroid, breast, cervix and kidney, with a single follicular dendritic cell sarcoma. Complications were minor and occurred in 10%.

Conclusion: Cervical lymph node biopsy is a safe, high-yield procedure when FNAC is inconclusive. Tuberculosis and lymphoma dominated, reflecting the region’s twin burden of infection and malignancy, and immunohistochemistry was central to reaching a diagnosis.