Clinicopathological Study of Granulomatous Lymphadenitis: A Descriptive Cross-Sectional Study of Patterns and Aetiological Insights in a Tertiary Care Centre.

Siri  Annam; Thirupathi   Thorram; Vemisetty    Praveen

doi:10.51168/sjhrafrica.v7i3.2496

Authors

Dr. Siri Annam Assistant Professor, Department of Pathology, JR Medical College, Tindivanam, Villupuram District, Tamilnadu, India
Dr. Thirupathi Thorram Assistant Professor, Department of Pathology, Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India
Dr. Vemisetty Praveen Consultant Radiologist, Medicare Diagnostics, Kothagudem, Telangana, India

DOI:

https://doi.org/10.51168/sjhrafrica.v7i3.2496

Keywords:

Granulomatous lymphadenitis, Tuberculous lymphadenitis, Sarcoidosis, Caseating granuloma, Acid-fast bacilli

Abstract

Background:
Granulomatous lymphadenitis represents a distinctive histopathological response to a wide spectrum of infectious and non-infectious causes. Despite tuberculosis being the predominant etiology in developing nations, the diverse morphological patterns often necessitate meticulous clinicopathological correlation to establish a definitive diagnosis.

Objectives:
To analyze the histomorphological patterns of granulomatous lymphadenitis, determine its etiological spectrum, and assess the diagnostic utility of ancillary staining methods in differentiating specific causes.

Materials and Methods:
A descriptive cross-sectional study was conducted in the Department of Pathology of a tertiary care teaching hospital over a two-year period. Fifty lymph node biopsy specimens reported as granulomatous lymphadenitis were included. Detailed clinical data were recorded. Histological examination was performed on formalin-fixed paraffin-embedded sections stained with hematoxylin and eosin. Ziehl–Neelsen (ZN) stain for acid-fast bacilli and Periodic Acid–Schiff (PAS) and Grocott Methenamine Silver (GMS) stains for fungi were employed when indicated.

Results:
The patients ranged from 8 to 72 years (mean 36.8 ± 14.2 years) with a female predominance (M: F = 1:1.3). Cervical lymph nodes were most commonly involved (70%). Caseating granulomas constituted 56%, non-caseating 28%, and suppurative 16%. Tuberculous lymphadenitis was the most frequent etiology (44%), followed by sarcoidosis (16%), cat-scratch disease (6%), and fungal lymphadenitis (4%), while 30% remained non-specific. Langhans giant cells were observed in 70% of cases, and a significant association was noted between necrosis and AFB positivity (p < 0.05).

Conclusion:
Tuberculosis continues to be the leading cause of granulomatous lymphadenitis in this region, predominantly affecting cervical nodes. Histopathology supported by special stains remains pivotal for accurate diagnosis.

Recommendations:
Routine use of AFB and fungal stains is strongly advised in all granulomatous lymphadenitis cases. Clinico-radiological correlation should be integrated to improve diagnostic precision and enable early therapeutic intervention.

Author Biographies

Dr. Siri Annam , Assistant Professor, Department of Pathology, JR Medical College, Tindivanam, Villupuram District, Tamilnadu, India

MBBS, MD, Assistant Professor, Department of Pathology, JR Medical College, Tindivanam, Villupuram District, Tamil Nadu, India. Dr. Siri Annam is an accomplished academic pathologist with strong expertise in histopathology, cytopathology, and hematopathology. She obtained her MBBS from Osmania Medical College, Hyderabad, in 2007, and completed her MD in Pathology from Kakatiya Medical College, Warangal, in 2011. Over her professional career, she has contributed extensively to undergraduate teaching, diagnostic pathology, and institutional research. Her key research interests include the clinicopathological correlation of infectious and inflammatory diseases, especially granulomatous lymphadenitis in endemic settings. Dr. Annam is committed to promoting evidence-based diagnostics, laboratory quality assurance, and the integration of morphology with molecular pathology for enhanced patient care. ORCID iD: https://orcid.org/0009-0008-4054-237X

Dr. Thirupathi Thorram , Assistant Professor, Department of Pathology, Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India

MBBS, MD (Pathology), currently serves as Assistant Professor in the Department of Pathology at Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India. He completed his undergraduate medical training (MBBS) followed by postgraduate specialization (MD) in Pathology, acquiring comprehensive expertise in histopathology, cytopathology, hematopathology, and clinical laboratory diagnostics.

His academic and clinical responsibilities include undergraduate and postgraduate teaching, diagnostic reporting, and participation in multidisciplinary clinicopathological discussions. Dr. Thorram has a keen interest in diagnostic cytology, oncopathology, and quality assurance in laboratory medicine. He has been actively involved in institutional research activities and contributes to scientific publications and academic conferences. His professional focus centers on strengthening evidence-based pathology practice and enhancing diagnostic accuracy in tertiary care settings.

Dr. Vemisetty Praveen , Consultant Radiologist, Medicare Diagnostics, Kothagudem, Telangana, India

MBBS, DMRD, completed his MBBS in June 2006 from Odessa State Medical University and obtained his Diploma in Medical Radiodiagnosis (DMRD) in November 2010 from Mamatha Medical College, Khammam. He served as a Senior Resident in the Department of Radiology at ASRAM Medical College, Eluru, from April 2013 to May 2019. He is presently working as a Consultant Radiologist at Medicare Diagnostics, Kothagudem, Telangana, India.

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