Abstract
Lymphadenopathy (LAP) is a common working diagnosis in the primary care setting; although the underlying etiology of this condition can be self-limiting, serious causes need to be ruled out. A clear understanding of lymph node (LN) location and patient demographics and exposure is vital in identifying which cases require rapid and extensive workup. The incidence of tuberculous (TB) lymphadenitis in the Central Region of Saudi Arabia (CRSA) has been reported to be 37.8%. In this study, we aimed to investigate the causes of LAP in this region. This was a retrospective study evaluating all patients who underwent LN biopsy at King Abdulaziz Medical City, Riyadh between 2007 and 2017. A total of 475 patients met the eligibility criteria. The mean age was 40.9 ± 25.5 years; 203 (42.7%) were females and 447 (94.1%) were Saudis. The causes of LAP were malignant in 240 (50.5%) and benign in 235 cases (49.4%). Forty two (8.8%) cases had TB lymphadenitis, but only 17 (40.5%) of those presented with systemic symptoms. Malignant causes were more common in adults compared to children, at 209 cases (55.4%) and 31 cases (31.6%), respectively (P = 0.0001). Patients who presented with generalized LAP were more likely to have a malignancy (P = 0.0000). Of the 234 who presented with systemic symptoms, 138 (59%) were diagnosed with cancer (P = 0.0000). Although less prevalent than before, TB lymphadenitis remains a significant medical problem in the CRSA. Malignancy must be ruled out, especially in those who present with generalized LAP and those with associated systemic symptoms.