iarjmsIARJMSIARJMS2708-3594https://doi.org/10.47310/iarjms.2023.v04i02.022Lymphadenopathy as Presentation of Underlying DiseasesYasirMohammedMahmodFouadJarullahAbdullahFirasMuntherMutaabBackground: The lymphadenopathy is a common finding in a large proportion of the patients, a doctor will have faced many cases presenting with lymph node enlargement and we need to decide it is within or outside the normal limits. and sometimes lymphadenopathy given us a clue about serious illness such as malignancy. a careful history and physical examination in some cases will be helpful to reach the diagnosis, in most cases we need to do FNA cytology and excisional biopsy to approve our diagnosis. Patients and Methods: This is a prospective study include 66 patients admitted to the baquba teaching hospital over and from general surgical outpatient clinic in a hospital a period of six months from 1st October 2014 to the 31st march 2015 with unknown cause of lymphadenopathy. We take carful history and examination to the patients and we support our diagnosis about whether it is lymph node or not by using radiological examination (U.S./C.T./ M.R.I.) then we do to the patients FNA cytology, excisional biopsy to reach to definitive diagnosis. Resuts: The most common age groups 31-40 years 31.9% most of the patients came to as from rural areas (50 cases 75.8%) and most common gender is male gender (38 cases 57.6%) with male to female ratio about 1.4:1, we found that most common patients with no family history of lymphadenopathy (61 cases 92.4 %) and the same number have –ve traveller history and most patients present to as with associated symptoms (49 case 74.2%) and the most common symptoms are swelling and fever (40 cases 31.2% , 31 cases 24.3%) and we notice the patients came to us with more than one symptom like fever , weight loss, anemia etc. And the most common anatomical site affected with lymphadenopathy is cervical region (29 cases 43.9%) and less common anatomical site is inguinal region (2 cases 3%). we do FNA cytology to all patients included in this study we found the most common finding is benign condition (43 cases 65.2%) and we give treatment to the patients with benign conditions only (10 cases) respond to treatment and in other 33cases we do excisional biopsy to them and we found (30 cases 90.9%) benign condition and only 3 cases malignant condition  and also we do excisional biopsy to patients with suspicious by FNA cytology (6 cases ) found (5 cases 83.3%) malignant condition and also we do excisional biopsy to malignant conditions (17 cases) we found (16 cases 94.1% ) malignant . In the results of excisional biopsy we found most common cases is (non-specific) reactive hyperplasia (13 case 23.2%) and acute lymphadenitis (10 cases 17.8%) and less common cases is leukemia (3 cases 5.5%). also in excisional biopsy we found (7 cases 12.6%) with secondary metastasis and we do search about primary site we found most common primary site is carcinoma of breast (3 cases 42.9%). Conclusions: The key factors considered when evaluating a patient with lymphadenopathy include the age of the patient, location of lymphadenopathy and associated symptoms. lymphadenopathy may be the first and sometimes the only presentation of underlying disease. we should not depend on clinical examination only to diagnose lymph node and we should depend on other diagnostic modalities such as ultra sound and C.T. scan. FNA cytology is useful triage for the rapid and definitive diagnosis of tuberculosis and other benign connditions but may miss malignancy so in most cases we need to do excisional biopsy to confirm our diagnosis. Aim of Study: To determine the most common causes of significant lymphadenopathy and common presenting complaints and most common anatomical sight of enlarge lymph nodes to the patients with lymph nodes enlargement.