Ayurvedic Diagnostic Perspective in Recurrent Cervical Lymphadenopathy (Apachi): A Case-Based Discussion

Recurrent cervical lymphadenopathy in pediatric and adolescent patients often presents a diagnostic challenge, particularly when repeated modern investigations fail to identify a clear underlying cause of the condition. In Ayurvedic literature, glandular swellings in the cervical region are described under the condition Apachi which is predominantly associated with Kapha and Vata dosha involvement and affects the Rasavaha and Mamsavaha srotas. This article describes a de-identified case of an adolescent patient with recurrent cervical lymphadenopathy [2] and a long-standing history of allergic rhinitis. Over several years, the patient underwent multiple evaluations, including fine-needle aspiration cytology, excision biopsy with immunohistochemistry, and PET-CT imaging. However, no evidence of malignancy or systemic pathologies was observed. From an Ayurvedic perspective, diagnostic assessment revealed several contributing factors such as habitual suppression of sneezing (Kshavathu Vega Dharana), incompatible dietary practices (Viruddha Ahara), irregular eating habits, and chronic Kapha–Vata vitiation leading to Ama formation. The condition is further explored through the concept of Kaphaja Krimi, providing an additional dimension to its pathogenesis. This case-based discussion highlights the relevance of Ayurvedic diagnostic principles, particularly Nidana Panchaka, in understanding recurrent and unexplained cervical lymphadenopathy and emphasises the importance of holistic evaluation in integrative clinical practices.