Title: Lymph node biopsies in a general internal medicine department: algorithm or individualized decision-making?
Authors: Verbrugge, Frederik ×
Stas, Marguerite
Knockaert, Daniel
Tousseyn, Thomas
Vanderschueren, Steven #
Issue Date: 2011
Publisher: Acta clinica belgica
Series Title: Acta Clinica Belgica vol:66 issue:4 pages:274-279
Abstract: Background: Lymphadenopathy (LA) imposes a diagnostic challenge in internal medicine. Exclusion of malignancy is the primary concern.
Methods: A retrospective case series, including 40 adult patients from the general internal medicine department who underwent lymph node biopsy (LNB) at a single university hospital. Demographics, clinical data and histopathological diagnoses were registered. By means of the latest medical record, we obtained a final diagnosis for each patient and subsequently searched for variables correlated with malignancy. Follow-up was at least one year in 95% of cases.
Results: The prevalence of malignancy was 58%. Older age (p=0.02) was significantly correlated with malignancy. The presence of painful lymphadenopathy at clinical examination (p=0.02) was significantly associated with a benign outcome. No single or combination of baseline variables satisfactorily excluded malignancy. Histopathological analysis correctly predicted malignancy in 93% of cases. In two cases, an initial diagnosis of benign non-specific lymphadenopathy was reversed to non-Hodgkin lymphoma. In one case the pathological diagnosis was inconclusive.
Conclusion: Rather than following a universal algorithm to determine the need for LNB in patients with LA, we call for individualized decision-making in each case, carefully appreciating all available information. Additionally, one should keep in mind that false-negative results occur due to sampling errors. Therefore, a minimal number of cases should end with a final diagnosis of benign non-specific lymphadenopathy. Intensive, multidisciplinary cooperation with surgeon and pathologist is needed. Moreover, clinical follow-up should be at least one year.
ISSN: 1784-3286
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory for Clinical Infectious and Inflammatory Disorders
Translational Cell & Tissue Research
Surgical Oncology
× corresponding author
# (joint) last author

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