Clinical Profile, Management, and Prognosis of Cervical Lymphadenopathy: A Study of 60 Patients at a District-Level Hospital

Open Access

Abstract

Background: Cervical lymphadenopathy has diverse infectious, inflammatory, and malignant causes, with tuberculosis remaining an important etiology in Bangladesh. Persistent or hard lymph nodes may indicate malignancy and require further evaluation. However, district-level evidence remains limited. This study evaluated the clinical profile, etiological patterns, management, and short-term outcomes of patients with cervical lymphadenopathy. Methods & Materials: A hospital-based observational study was conducted among 60 patients with cervical lymphadenopathy at Jamalpur Medical College Hospital from March 2025 to February 2026. Demographic and clinical data were collected, and diagnosis was established through clinical examination, ultrasonography, FNAC, biopsy, and relevant investigations. Management and short-term outcomes were assessed. Data were analyzed using SPSS version 26.0, with p<0.05 considered significant. Results: In a group of 60 patients, the average age was 36.8 ± 17.2 years, with a higher percentage of males (56.7%); 63.3% hailed from rural regions. Neck swelling occurred in all cases (100%), followed by fever (51.7%) and pain/tenderness (33.3%). The majority exhibited unilateral (66.7%) and firm (51.7%) lymphadenopathy, with 48.3% ranging from 2 to 4 cm. FNAC was conducted in 86.7% of individuals. Tuberculous lymphadenitis was the most common diagnosis (35.0%), succeeded by reactive/infective lymphadenitis (26.7%) and malignancy (28.4%). The most prevalent treatment was anti-tubercular therapy (35.0%). Malignancy showed a significant correlation with age over 40 years (p=0.002), weight reduction (p=0.004), and firm lymph-node texture (p<0.001). Conclusion: Tuberculosis was the leading cause of cervical lymphadenopathy, while older age, weight loss, and hard lymph nodes were significantly associated with malignancy. Early FNAC or biopsy is essential for accurate diagnosis and appropriate management.