Histopathologic spectrum of lymph node disease in a lagos facility

Background and Objective: Hematopathology is often a technical and challenging aspect of pathology, requiring robust ancillary testing and second specialist opinion, both of which are not readily available and affordable to the Nigerian population. The aim of this study, therefore, was to determine the histological spectrum of lymph node diseases and highlight the diagnostic challenges. Methodology: A retrospective review of lymph node biopsies submitted to The Specialist Laboratories, Lagos, Nigeria, over an 8-year period was carried out. A proportion of these had a specialist's second opinion and ancillary immunohistochemistry testing where necessary. Results: Two hundred and ten lymph node biopsies were studied. Majority of the cases were diagnosed as nonspecific reactive changes (31.0%). This was followed by metastases to the lymph nodes (22.9%) and lymphomas (18.6%). Non-Hodgkin's lymphoma accounted for 79.5% of lymphomas, of which small cell lymphoma (35.5%) and diffuse large B-cell lymphoma (29.0%) were the most predominant subtypes. There was a 62.1% concordance between the preliminary and final diagnoses. Conclusion: These morphologic findings are in keeping with those in published literature. A significant number of discordant cases highlight the need for specialist training in hematopathology as well as the establishment of well-equipped facilities for accurate and cost-effective diagnosis.