Clinical, Cytological, Histopathological and Immunohistochemical Features of a T-Zone Lymphoma in a Mixed-Breed Dog

Background: Non-Hodgkin lymphoma are a group of lymphoid neoplasms originated from the proliferation of precursors or mature, T, B and/ or NK lymphocytes. T-Zone lymphoma (TZL) is characterized as an indolent lymphoma due to its slow progression and poor chemotherapy´s response. Dogs affected by this neoplasm may live for many years without clinical signs and are often underdiagnosed. The aim of the present article is report a TZL case in a nine-year old male mixed breed dog, submitted to clinical follow-up and chemotherapy. Case: A nine-year old male mixed-breed dog was presented due to the observation of an increased left mandibular lymph node. The previous cytological examination was suggestive of reactive hyperplasia and histopathological examination, by incisional biopsy, compatible with lymphocytic low-grade lymphoma. Physical examination revealed enlarged and firm left mandibular lymph node and adequate physical condition.A cytological examination was performed in the mandibular and both popliteal lymph nodes and revealed many small lymphocytes with hyperchromatic chromatin, rarely evident nucleolus and whose cytoplasm often projected in the form of a “hind-mirror” or “comet tail”, compatible with lymphocytic lymphoma (low grade) and suggestive of TZL, in the both lymph nodes. The histopathological and immunohistochemical examination, of the mandibular lymph node, were chosen to confirm the diagnosis. At histopathology it was observed 40% of the sample contained a monotonous cell population, composed by small lymphocytes, with some presenting “hand-mirror” morphology. Two mitotic figures were evidenced per field of high magnification (40x), inferring a low-grade disease. Immunohistochemical analysis revealed neoplastic proliferation with immunolabeling of CD3 lymphocytes and positivity for Ki-67, but negative for CD20, CD79a, CD45, MUM-1 and PAX-5. Although there is no consensus about requirements and treatment´s efficacy, it has been chosen to treat the dog with chlorambucil, because of the elevated Ki-67 value (48%). The patient obtained a free-progression interval higher than 820 days, from the earlier investigations of lymphadenopathy, with excellent quality of life and no side effects related to the use of chlorambucil. Discussion: Although TZL is a common subtype of lymphoproliferative disease in dog, it is still underdiagnosed. The TZL diagnosis can be suggested by cytology, from the disclosures in neoplastic cells of a cytoplasmic projections, recognized as a “hand-mirror” or “comet tail”, corroborated with the present case, however the histopathology is confirmatory. Immunohistochemistry in which the neoplasm cells showed a positive immunolabeling for CD3 and negative for CD79a, CD20, CD45, MUM1 and PAX5, as evidenced in this report, confirming the T-cell origin. According to the literature, lymphomas composed by small clear cells and cytoplasm projecting by cytology, immunolabeling CD3 and CD25 positive and CD45 negative are, together, findings that confirmed TZL. The biological behaviour of indolent lymphoma is still largely unknown, however the prognosis of dogs, with indolent lymphoma of T or B cells, seems to be favourable. Studies showed different days of median overall survival, such as 760 days and 4.4 years. In the present case, the dog showed 820 days, confirming the good prognosis and an indolent behavoiur. Aggressive chemotherapy protocols are not necessary for such cases and the treatment with chlorambucil, without the association of prednisolone, has been well tolerated by the patient, which showed no side effects until the moment.

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Primary Mucoepidermoid Carcinoma Arising from Ectopic Salivary Tissue within an Intraparotid Lymph Node

Case Reports in Otolaryngology ◽

10.1155/2015/879137 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Fatemah Faras ◽

Fawaz Abo-Alhassan ◽

Jassem Bastaki ◽

Mutlaq K. Al-Sihan

Keyword(s):

Salivary Gland ◽

Lymph Node ◽

Lymph Nodes ◽

Needle Aspiration ◽

Low Grade ◽

Warthin Tumor ◽

Diagnostic Pitfall ◽

Deep Margin ◽

Intermediate Cells ◽

The Right

Ectopic salivary tissue is commonly found in intraparotid and periparotid lymph nodes. Warthin tumor is the most common tumor arising in ectopic salivary gland tissue and in intraparotid lymph nodes. Although rare, neoplastic transformation of the ectopic salivary tissues is conceivable and other types of salivary gland neoplasms arising in intraparotid lymph nodes have been reported. Herein we report a rare case of a 32-year-old Kuwaiti male who presented with a mass in the right parotid gland. A preoperative fine needle aspiration suggested Warthin tumor. The patient underwent a superficial parotidectomy. The specimen showed a mass within the parotid parenchyma abutting the deep margin. Hematoxylin and Eosin stained sections of the lesion showed solid islands and cysts composed of epidermoid cells, mucus cells, and intermixed smaller “intermediate” cells within an intraparotid lymph node. The tumor was seen infiltrating the parotid parenchyma at the deep margin. Metastasis from distant sites was ruled out clinically, and the diagnosis rendered was MEC, low-grade, arising from ectopic salivary tissue in an intraparotid lymph node. Such cases are extremely rare and the presence of malignancies within lymph nodes may pose a diagnostic pitfall, which can affect patient management.

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Characterization of Morphologic Changes and Lymphocyte Subset Distribution in Lymph Nodes from Cats with Naturally Acquired Feline Immunodeficiency Virus Infection

Veterinary Pathology ◽

10.1177/030098589202900504 ◽

1992 ◽

Vol 29 (5) ◽

pp. 391-399 ◽

Cited By ~ 30

Author(s):

B. A. Rideout ◽

L. J. Lowernstine ◽

C. A. Hutson ◽

P. F. Moore ◽

N. C. Pedersen

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Feline Immunodeficiency Virus ◽

Clinical Stage ◽

Relative Proportion ◽

Prognostic Significance ◽

Clinical Signs ◽

Methyl Green ◽

Feline Immunodeficiency Virus Infection ◽

Immunodeficiency Virus

Lymph nodes were collected at biopsy or necropsy from 18 cats with naturally acquired symptomatic feline immunodeficiency virus (FIV) infection and from 18 seronegative cats. Thirty-five of the cats were domestic shorthairs and one was a Persian cross. The cats ranged from 7 months to 16 years of age and were mainly obtained from California veterinary practitioners, a California cattery, and a Veterinary Teaching Hospital. Based on clinical signs present at tissue collection, ten FIV-infected cats fell into the acquired immunodeficiency syndrome (AIDS)-related complex (ARC) clinical stage and eight in the terminal (AIDS) stage of FIV disease. All cats were FeLV negative by antigen ELISA. Histologic sections of lymph nodes from each cat were examined blindly and were categorized as hyperplastic, involuting, mixed hyperplastic and involuting, depleted, or normal based upon subjective evaluation of follicles and paracortex. The relative abundance of plasma cells was evaluated in methyl green pyronin (MGP) and hematoxylin and eosin-stained sections. Similar numbers of FIV-seropositive and -seronegative cats fell into each lymph node category. The only difference evident between FIV-infected cats and control cats was in the degree of plasmacytosis present; moderate to marked plasmacytosis was present in 13/18 FIV-infected cats but in only 3/18 control cats. Immunohistochemical staining of frozen lymph node sections from six FIV-infected cats and 12 control cats for CD4, CD8, Factor VIII-related antigen, and a B cell/follicular dendritic cell-specific (CD21-like) antigen revealed only a slight increase in the relative proportion of paracortical CD8+ lymphocytes versus CD4+ lymphocytes in lymph nodes from FIV-infected cats. These findings suggest that lymph node changes previously considered to be specific or highly suggestive of lentivirus-induced immunodeficiency disease are actually not specific but occur in FIV-seronegative cats as well. Despite this lack of specificity, lymph node changes seen in FIV-infected cats may have prognostic significance. All cats in the ARC stage had hyperplastic or mixed hyperplastic and involuting nodes, whereas those in the AIDS stage had either involuting or depleted nodes, which suggests that the clinical stage of disease correlates with the category of lymph node change.

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Morphological characteristic of inguinal lymph nodes in HIV infection

Perm Medical Journal ◽

10.17816/pmj36251-59 ◽

2019 ◽

Vol 36 (2) ◽

pp. 51-59

Author(s):

N. I. Gulyaeva ◽

G. G. Freind ◽

N. G. Shmagel ◽

L. B. Korolevskaya ◽

E. V. Saidakova ◽

...

Keyword(s):

Lymph Node ◽

Antiretroviral Therapy ◽

T Lymphocytes ◽

Hiv Infection ◽

Lymph Nodes ◽

Blood Lymphocyte ◽

Ki 67 ◽

Inguinal Lymph Nodes ◽

Group I ◽

Lymphocyte Number

Aim. To assess the morphological changes in inguinal lymph nodes among patients with stage 4a HIV infection, who receive antiretroviral therapy. Materials and methods. There were examined 12 HIV-infected patients with stage 4a, treated at “Perm Regional Center for Prevention and Fight against AIDS and Infectious Diseases”, who received antiretroviral therapy for 2 years. Two groups of patients were formed: group I – 6 persons, whose CD+ blood lymphocyte number was more than 350 in 1 mcl; group II – 6 persons with CD+ blood lymphocyte number less than 350 in 1 mcl. Inguinal lymph nodes (ILN) were taken under local anesthesia, histological preparations were prepared by traditional scheme, stained with hematoxylin and eosin using Masson three-colour staining. In immunohistochemical reactions expression of Ki-67 and CD+ markers was estimated. Results.Histoarchitectonics of lymph nodes was changed as a result of massive development of sclerosis in the region of hilum, capsule and trabecules. Against the background of sclerosis, there occurred lymphocyte depletion, change in structure of stromal cells and neoangiogenesis in all the zones of the lymph node. In the regions of sclerosis, death of lymphocytes was revealed. In patients of the second group, more active development of follicles with the centers of reproduction in the lymph node cortical substance, as well as growth of the number of Ki-67 maker-expressing cells was established Conclusions.In the inguinal lymph nodes, the development of sclerotic processes causes the death of T-lymphocytes, which, in their turn, are the source of lymphotoxin-β formation. Loss of CD+-T-lymphocytes is accompanied by deficit of lymphotoxin-β and induces the loss of fibroblastic reticular cells themselves, which through the production of IL-7 support the vital activity of T-cells.

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Ultrasonographic, endoscopic and histological appearances of the caecum in cats presenting with chronic clinical signs of caecocolic disease

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x16663594 ◽

2016 ◽

Vol 19 (2) ◽

pp. 94-104 ◽

Cited By ~ 9

Author(s):

Harriet Hahn ◽

Pascaline Pey ◽

Aurélie Baril ◽

Julie Charpentier ◽

Loic Desquilbet ◽

...

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Clinical Signs ◽

Wall Thickening ◽

Abdominal Ultrasonography ◽

Tissue Samples ◽

Mesenteric Fat ◽

Lymph Node Size ◽

Histological Characteristics ◽

Node Size

Objectives This study aimed to describe the ultrasonographic, endoscopic and histological characteristics of the caecum and ileocaecocolic junction in cats suffering from chronic clinical signs compatible with caecocolic disease. Methods Cats presenting with clinical signs suggestive of a caecocolic disease were prospectively recruited. All cats underwent an ultrasonographic examination of the caecum, ileum, colon, ileocolic lymph nodes and local mesenteric fat, in addition to comprehensive abdominal ultrasonography. This was followed by a colonoscopy with a macroscopic assessment of the caecocolic mucosa; caecocolic tissue samples were systematically collected for histologic analysis. Results Eighteen cats were included. Eleven of 18 cats had ultrasonographic abnormalities adjacent to the ileocaecocolic junction (lymphadenopathy, local steatitis) and 13/18 cats had abnormalities directly related to the junction (wall thickening, loss of wall layering). Seventeen of 18 cats had at least one ultrasonographic abnormality. Endoscopically, hyperaemia, oedema, discoloration and/or erosions were found in all cats. Each cat was classified as having mild or moderate-to-severe lesions according to endoscopic results; no classification could be established statistically for ultrasonographic results. The accentuation of the dimpled pattern tended to be inversely related to the severity of endoscopic lesion scoring. Histologically, a large proportion of cats showed typhlitis (13/16), one had lymphoma and two were normal. All cats with typhlitis also had colitis. There was only slight agreement between endoscopic and histological caecal results regarding the severity of lesions. Loss of caecal wall layering on ultrasound was found in 7/18 cats and, surprisingly, did not appear as a reliable predictor of the severity of inflammation or of malignancy; neither did local steatitis nor lymph node size. Conclusions and relevance Ultrasonography and endoscopy should not be used as the sole methods to investigate the ileocaecocolic region in cats with clinical signs suggestive of caecocolic disease. The presence of chronic clinical signs should routinely prompt histological biopsy.

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Apocrine Gland Anal Sac Adenocarcinoma in Dogs: 22 Cases (2015-2020)

Indian Journal of Animal Research ◽

10.18805/ijar.b-4371 ◽

2021 ◽

Author(s):

A.K. Sahoo ◽

I. Nath ◽

S.B. Senapati ◽

S.K. Panda ◽

M.R. Das ◽

...

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Regional Lymph Node ◽

Clinical Signs ◽

Clinical Staging ◽

Apocrine Gland ◽

Survival Times ◽

Regional Lymph Nodes ◽

Iliac Lymph Node ◽

Anal Sac

Background: Apocrine gland anal sac adenocarcinoma (AGASACA) is a highly malignant disease mostly invading regional lymph nodes at the time of disease diagnosis.Methods: Twenty- two cases of Apocrine gland anal sac adenocarcinoma (AGASACA) were treated during five years. Contrast radiography with Iohexol and Lipidol were carried out to detect primary anal sac mass and regional lymph node through indirect lymphography technique. For clinical staging, ultrasonography, fine-needle aspiration cytology, histopathology of both primary tumor mass and regional lymph node were performed. Closed anal Sacculectomy was performed as curative therapy for anal sac adenocarcinoma.Result: The median age and weight of dogs at presentation were 8.4 years and 20.9 kg, respectively. Diagnostic radiology, histopathology and biochemical assay confirm twenty-two cases of anal sac adenocarcinoma and medial iliac lymph node to be sentinel lymph node. Carcinoma was of unilateral occurrence in all the dogs. Four (18%) dogs had hypercalcemia and twelve (54%) had metastases to the regional lymph nodes with clinical signs of tenesmus or constipation, polyuria -polydipsia and anorexia. Apocrine gland Adenocarcinoma of anal sac was found to initially metastasize to the medial iliac lymph node. Survival times of dogs treated with the surgical procedure only (8 out of 22 dogs) were appreciably longer than the dogs with therapeutic only. Animals with metastasis to regional lymph nodes or lymphadenopathy had poor prognosis.

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Profiles of expression of activated cell antigens on peripheral blood and lymph node cells from different clinical stages of adult T-cell leukemia

Blood ◽

10.1182/blood.v73.6.1664.1664 ◽

1989 ◽

Vol 73 (6) ◽

pp. 1664-1671 ◽

Cited By ~ 40

Author(s):

K Shirono ◽

T Hattori ◽

H Hata ◽

H Nishimura ◽

K Takatsuki

Keyword(s):

T Cells ◽

Lymph Node ◽

T Cell ◽

Lymph Nodes ◽

Peripheral Blood ◽

Cell Leukemia ◽

Ki 67 ◽

Adult T Cell Leukemia ◽

Hla Dr ◽

Clinical Stages

Abstract The expression of activated cell antigens (Ags) on adult T cell leukemia (ATL) cells at different clinical stages (acute, chronic, and smoldering), and ATL cells from enlarged lymph nodes were studied using monoclonal antibodies (MoAbs). The expressions of CD25 (Tac), CD28, T9 (transferrin receptor), and Ki-67 (proliferating cell nuclear antigen) Ags were high, and that of CD7 Ag was low in both acute and chronic ATL cells compared with that in normal T cells. The expressions of T9 and Ki-67 Ags were higher in acute ATL cells than in chronic ATL cells. The expression of CD38 Ag was higher in acute ATL cells but not in chronic ATL cells compared with normal T cells. On the contrary, the expression of HLA-DR Ag on the cell surface and the transcript of the HLA-DR Ag gene were high in chronic ATL cells, but not in acute ATL cells. A high percentage of lymph node ATL cells expressed T9, CD38, and Ki-67 Ags, although the peripheral blood ATL cells of the same patients showed significantly lower levels of expression of the same Ags. Interestingly, CD7 and HLA-DR Ags were detected on the majority of lymph node ATL cells. Moderately high percentage of smoldering ATL cells expressed CD25, CD28, and HLA-DR Ags, though a few numbers of leukemic cells were present in the samples. These findings confirm that the modes of activation of ATL cells in different clinical stages differ, and suggest that the differences might be reflected in the clinical features. The low expression of HLA-DR Ag in acute ATL cells, despite high expression of the Ag in chronic ATL cells, suggests that successive events that suppress HLA-DR Ag expression are necessary for the transformation of chronic ATL cells into acute ATL cells. Moreover, the high expressions of T9, CD38, Ki-67, CD7, and HLA-DR Ags on lymph node ATL cells indicate that ATL cells preferentially proliferate in lymph nodes.

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Enzootic nasal adenocarcinoma in small ruminants in Jordan

Veterinarska stanica ◽

10.46419/vs.51.2.12 ◽

2020 ◽

Vol 51 (2) ◽

pp. 219-223

Author(s):

Wael Hananeh ◽

Myassar El-Ekish ◽

Rami Mukbel ◽

Zuhair Bani Ismail ◽

Mousa Daradka

Keyword(s):

Histopathological Examination ◽

Clinical Signs ◽

Small Ruminants ◽

Radiographic Examination ◽

Low Grade ◽

Cytological Examination ◽

Awassi Sheep ◽

Nasal Adenocarcinoma ◽

Nasal Passages ◽

First Time

Enzootic nasal adenocarcinoma (ENA) is a viral-associated tumor of the secretory epithelium of the nasal passages of small ruminants. The tumor is locally invasive but not metastatic. Although disease prevalence (up to 15%) and geographic distribution have been reported in the literature throughout most of the world (except Australia and New Zealand), the disease has until now remained unreported in Jordan. In this report, we describe the occurrence, clinical signs, radiographic signs and pathological features of the disease in a series of cases in Awassi sheep (3 cases) and Damascus breed goats (2 cases) for the first time in Jordan. Overall, the affected animals were adults (3-5 years of age), all females, with variable degrees of facial and nasal deformities resulting in difficulty in respiration. Radiographic examination of the skull revealed soft tissue density mass originating in the nasal turbinate and invading the surrounding nasal structures. Cytological examination of fine needle aspirate indicated low-grade carcinoma. All animals were humanely euthanized and the nasal passages were explored. Variable size masses were removed and histopathological examination confirmed the diagnosis of enzootic nasal adenocarcinoma.

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Predicting of Sentinel Lymph Node Status in Breast Cancer Patients with Clinically Negative Nodes: A Validation Study

Cancers ◽

10.3390/cancers13020352 ◽

2021 ◽

Vol 13 (2) ◽

pp. 352

Author(s):

Annarita Fanizzi ◽

Domenico Pomarico ◽

Angelo Paradiso ◽

Samantha Bove ◽

Sergio Diotaiuti ◽

...

Keyword(s):

Prognostic Factors ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Lymph Nodes ◽

Machine Learning Algorithms ◽

Lymph Node Status ◽

Breast Cancer Patients ◽

Ki 67 ◽

Node Status ◽

Sentinel Lymph Node Status

In the absence of lymph node abnormalities detectable on clinical examination or imaging, the guidelines provide for the dissection of the first axillary draining lymph nodes during surgery. It is not always possible to arrive at surgery without diagnostic doubts, and machine learning algorithms can support clinical decisions. The web calculator CancerMath (CM) allows you to estimate the probability of having positive lymph nodes valued on the basis of tumor size, age, histologic type, grading, expression of estrogen receptor, and progesterone receptor. We collected 993 patients referred to our institute with clinically negative results characterized by sentinel lymph node status, prognostic factors defined by CM, and also human epidermal growth factor receptor 2 (HER2) and Ki-67. Area Under the Curve (AUC) values obtained by the online CM application were comparable with those obtained after training its algorithm on our database. Nevertheless, by training the CM model on our dataset and using the same feature, we reached a sensitivity median value of 72%, whereas the online one was equal to 46%, despite a specificity reduction. We found that the addition of the prognostic factors Her2 and Ki67 could help improve performances on the classification of particular types of patients with the aim of reducing as much as possible the false positives that lead to axillary dissection. As showed by our experimental results, it is not particularly suitable for use as a support instrument for the prediction of metastatic lymph nodes on clinically negative patients.

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Low-Grade Ovarian Serous Adenocarcinoma with Lymph Node Metastasis in Neck

Diagnostics ◽

10.3390/diagnostics11101804 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1804

Author(s):

Shih-Lung Chen ◽

Tsan-Yu Hsieh ◽

Shih-Wei Yang

Keyword(s):

Ovarian Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Neck Mass ◽

Serous Carcinoma ◽

Low Grade ◽

Serous Adenocarcinoma ◽

Ovarian Serous Adenocarcinoma ◽

The Right ◽

Radioactivity Uptake

Low-grade ovarian serous adenocarcinoma is rarely encountered in the neck region. The diagnosis of this rare malignancy entity in the neck is challenging for both clinicians and pathologists. A 53-year-old female with a chief complaint of a right lower neck mass that had been growing for approximately 2 weeks. The ultrasound-guided fine needle aspiration cytology favored malignancy. The positron emission tomography/computed tomography scan revealed the clustered enlarged lymph nodes with increased radioactivity uptake in the right neck level V, and strong radioactivity uptake was also displayed in the right ovarian regions. Pelvis magnetic resonance imaging displayed right adnexal complex mass supporting the ovarian cancer. An en bloc resection of the right neck lymph node was conducted. Ovarian serous adenocarcinoma with metastasis of lymph nodes in the neck was confirmed through histopathological findings. This study reviews the clinical features of low-grade ovarian serous carcinoma metastasizing to lymph nodes in neck. Although very rare, ovarian cancer with neck metastasis should be considered in the differential diagnosis of a neck mass lesion. The clinical staging would be relatively high due to the quiet entity of the cancer.

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Clinicopathological Study on TB Lymphadenopathy Case

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v20i1.53593 ◽

2021 ◽

Vol 20 (1) ◽

pp. 77-80

Author(s):

Mohammad Mahabubul Alam Chowdhury ◽

Pran Gopal Datta ◽

Abu Sahfi Ahmed Amin ◽

Khondakar Abdullah Al Mahmud ◽

Kawsar Sultana

Keyword(s):

Lymph Nodes ◽

Extrapulmonary Tuberculosis ◽

Tertiary Care ◽

Clinical Signs ◽

Epithelioid Cell ◽

Low Grade ◽

Care Hospital ◽

Caseating Granuloma ◽

Supraclavicular Lymph Nodes ◽

History Of

Background: Tuberculosis in the form of pulmonary and extrapulmonary TB is common in developing countries like Bangladesh. Among extrapulmonary TB, lymphnode TB is still common in our setting. So, the objectives of the present study were to evaluate theclinicopathological findings among the lymphnode TB cases in our context. Materials and methods: This observational study was done from January 2017 to December 2019 among 300 lymphnode TB cases in a tertiary care hospital during a three-year study period. Patients were selected after obtaining informed written consent and clinical evaluation. Then enlarged lymphnodes were evaluated by FNAC or histopathology. If lymphnode TB features were found then the patients were included in our study.Other findings like metastasis, lymphoma or pyogenic lymphadenitis were excluded from this study. After collection, data was recorded and analyzed by Microsoft Excel. Results: Among 300 cases of TB lymphadenitis subjects were commonly within the age groups 11-20 years (Male 63 and female 51) and 21-30 years(male 45 and female 42) with amale: female ratioof 1.22:1. Regarding different clinical signs and symptoms,low grade fever was found in 21(7%) cases, local lymphnode pain and tenderness was found in 67 (22%) and 63(21%) of subjects. Discharging sinuses was present in 33(11%) patients, 35(12%) had history of weight loss, 39 (13%) had anorexia and 42(14%) had history of night sweats. Regarding locationof different lymph node areas, 125(41.67%) patients had deep cervical nodes, 65(21.67%) had supraclavicular lymph nodes, 60(20%) had lymph nodes in the posterior triangle 33 (11%) in jugulo-omohyoid and 17 (5.66%) in submandibular area. Among all cases, 83% cases showed bilateral and 17% showed unilateral involvement.Regarding nature of lymph nodes, firm, matted multiple lymphnodes were found in 130(43%) cases, single discrete nodes were found in 70(23.33%) cases, others were found as suppurative noded with single and multiple sinuses. Cytopathological and histopathological findings revealed caseating granuloma with epithelioid cell with Langerhans type giant cell was found in 220(73%) cases, caseating granuloma with epithelioid cell was found in 47(16%) epithelioid cell was found in 20(7%) cases and epitheliod cells with smear positive AFB was found in 13(4%) cases. Conclusion: TB lymphadenitis is still a common form of extrapulmonary tuberculosis and it has variable clinical and pathological presentations. Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 77-80

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