Demographic, clinical and laboratory characteristics for differential diagnosis of peripheral lymphadenopathy (LAP) and the etiologic distribution of LAP in adults; a multicenter, nested case–control study including 1401 patients from Turkey

Yeni̇lmez, Ercan; Verdi, Yıldız; Ilbak, Ayca; Demirkiran, Burcu Caliskan; Duman, Zehra; Bozkurt, Fatma; Seyman, Derya; Aşan, Ali; Eker, Halime Betül Şahin; Ceylan, Mehmet Reşat; Emre, Salih; Altunyurt, Gozde Ozturk; Ayan, Saliha; Parlak, Emine; Toros, Göknur Yapar; Yörük, Gülşen; Karaagac, Leman; Özgüler, Müge; Meral, Busra; Ay, Muzeyyen; Öztürk, Çınar; Karacaer, Zehra; Tural, Ersin; Çeti̇nkaya, Rıza Aytaç; Dökmetaş, İlyas; Köse, Şükran

doi:10.1007/s11739-021-02683-2

Cited by 3 publications

(5 citation statements)

References 13 publications

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“…In contrast, patients with axillary or inguinal LAP, hepatomegaly and splenomegaly were unlikely to have TBLN. In our previous study, including patients with and without lymph node histopathology, the probability of having an infectious etiology was significantly higher in patients with localized and unilateral LAP, while hepatomegaly and splenomegaly were not associated with increased risk in terms of infectious or non-infectious diseases; however, we did not evaluate these results in terms of TBLN [6]. The duration or size of the lymph node revealed no importance in the differential diagnosis of LAP in the discrimination of TBLN from other causes [23].…”

Section: Discussionmentioning

confidence: 77%

“…As the second most frequent cause, approximately one-quarter of the cases were considered to have reactive LAP or a non-specific etiology. The proportions of this group in our previous multicenter study including 1,401 cases were 44.3% and 77.2% in patients with and without histopathology, respectively [6]. The ratio of reactive and/or non-specific lymphadenitis ranges from 28.4% to 52.2% in histopathology-based studies in the literature [7,16,17].…”

Section: Discussionmentioning

confidence: 95%

“…The incidence of lymphadenopathy (LAP), etiological spectrum, and clinical manifestations of LAP may differ by geographical region due to factors including socioeconomic factors, rate of the elderly population, people living with human immunodeficiency virus (HIV), or improvement in diagnostic procedures. However, excluding unidentified cases or non-specific etiologies, TBLN is the leading cause of LAP, especially in developing countries [6][7][8]. Other possible causes of LAP include infectious diseases; immunological, neoplastic, and metabolic disorders; medications; and iatrogenic causes.…”

Section: Introductionmentioning

confidence: 99%

“…A good medical history and physical examinationincluding patient age, duration and location of LAP, exposures, associated symptoms, travel history, and occupation-usually help identify the cause of LAP [9]. However, it is always a long and challenging process to reach a definitive differential diagnosis, especially in patients who represent generalized LAP, and, it is not possible to have a definitive diagnosis in a considerable proportion of these patients [6]. Peripheral LAP, including TBLN, is generally asymptomatic and TBLN mimics various infectious and non-infectious diseases, including mycobacterial or bacterial adenitis, fungal diseases, toxoplasmosis, tularemia, cat-scratch disease, sarcoidosis, non-specific hyperplasia, and primary or metastatic neoplasms; therefore, diagnosis often requires lymph node biopsy for both pathological and microbiological investigations [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic approach of tuberculous lymphadenitis in a multicenter study

Yenilmez,

Özakınsel,

Köse

et al. 2024

J Infect Dev Ctries

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Introduction: Tuberculous lymphadenitis (TBLN) is the most common infectious etiology of peripheral lymphadenopathy in adults, in Turkiye. This study aimed to identify the demographic, clinical, and laboratory variables that differentiate TBLN from non-tuberculous lymphadenitis (NTBLN), as well as the etiology of lymphadenopathy in adults. Methodology: Patients who were over 18 years old and were referred to the infectious disease outpatient clinics with complaints of swollen peripheral lymph nodes, and who underwent lymph node biopsy between 1 January 2010 and 1 March 2021, were included in this multicenter, nested case-control study. Results: A total of 812 patients at 17 tertiary teaching and research hospitals in Turkiye were included in the study. TBLN was the most frequent diagnosis (53.69%). The proportion of patients diagnosed with TBLN was higher among females; and among those who had a higher erythrocyte sedimentation rate, positive purified protein derivative test, and positive interferon-gamma release test result (p < 0.05). However, TBLN was less frequent among patients with generalized lymphadenopathy, bilateral lymphadenopathy, axillary lymphadenopathy, inguinal lymphadenopathy, hepatomegaly, splenomegaly, leukocytosis, and moderately increased C reactive protein levels (p < 0.05). Conclusions: Identifying the variables that predict TBLN or discriminate TBLN from NTBLN will help clinicians establish optimal clinical strategies for the diagnosis of adult lymphadenopathy.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnostic approach of tuberculous lymphadenitis in a multicenter study

Yenilmez,

Özakınsel,

Köse

et al. 2024

J Infect Dev Ctries

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“…Lymphadenopathy occurs due to various conditions, such as infectious, immune or neoplastic diseases, and metabolic disorders, as well as drug or iatrogenic causes ( 5 , 6 ). Generally, lymph nodes smaller than 1 cm in diameter are considered benign.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Diagnostic Excisional Lymph Node Biopsy Results: 12-Year Experience of a Single Center

Bayhan

2023

ACC

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SUMMARY Lymph node biopsy is indicated in patients with suspected malignancy or lymphadenopathy due to unclarified reasons. Lymph node biopsy can be performed as fine needle aspiration biopsy, core biopsy, or excisional lymph node biopsy. In particular, the diagnosis of malignant lymphoma is considered insufficient for oncological treatment unless classified into subgroups. Core biopsy and excisional biopsy can be performed to diagnose lymphoma and classify it into subgroups. Core biopsy may also be limited in some cases for the diagnosis of lymphoma. Therefore, patients are referred to surgical departments for excisional lymph node biopsy. It was aimed herein to analyze the results of excisional lymph node biopsies performed for diagnostic purposes in our department. Data on 73 patients having undergone diagnostic excisional lymph node biopsy at Sakarya University Medical Faculty Training and Research Hospital between January 2008 and January 2020 were retrospectively analyzed. Patients were evaluated in terms of age, gender, biopsy site, pathological diagnosis, number and diameter of lymph nodes excised. Patients younger than 18 years of age, those with sentinel lymph node biopsies, and lymph node dissections performed for any known malignancy were excluded from the study. Statistical data analysis was done using SPSS statistical software. There were 37 (50.7%) female and 36 (49.3%) male patients, mean age 52.07 (18-90) years. Axillary lymph node biopsy was performed in 32 patients, inguinal lymph node biopsy in 29 patients, cervical lymph node biopsy in 3 patients, intra-abdominal lymph node biopsy in 6 patients, mediastinal lymph node biopsy in 1 patient, and supraclavicular lymph node biopsy in 2 patients. All of the lymph node biopsies were performed as excisional biopsy. Malignancy was detected in 36 (49.3%) patients. In 37 (50.3%) patients, the causes of lymphadenopathy were found to be benign pathologies. When the causes of malignant disease were examined, it was observed that 23 (31.5%) patients were diagnosed with lymphoma. Hodgkin lymphoma was detected in 5 patients diagnosed with lymphoma, and non-Hodgkin lymphoma was found in 18 patients. Metastatic lymphadenopathy was observed in 13 (17.8%) patients. Reactive lymphoid hyperplasia (26%) and lymphadenitis (20.5%) were found among the causes of benign lymphadenopathy. The number of excised lymph nodes was between 1 and 4, and their diameter was between 9 and 75 mm (mean: 29.53±15.56 mm). There was no statistically significant difference between benign and malignant patients according to gender, age, lymph node diameter, number of lymph nodes excised, and excisional lymph node biopsy site. For diagnostic lymph node biopsy, fine-needle aspiration biopsy and core biopsy should be performed primarily. If lymphoma is suspected in the diagnosis, fine-needle aspiration biopsy is not necessary. In this case, it is believed that it is more appropriate to perform core biopsy first. If the core biopsy is insufficient for diagnosis, it is more ap...

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Çocukluk çağı Kronik ve Persistan Lenfadenopatilerin Ultrason ve Laboratuvar Veriler eşliğinde Öngörülebilirliği; Bir Çocuk Hematoloji-Onkoloji Polikliniği Deneyimi

ÇAKMAK,

ÖZEL

2024

Ağrı Tıp Fakültesi Dergisi

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Aim: Lymphadenopathies occupy an important part of pediatric hematology-oncology practice. More than 95 per cent of cases are known to be reactive, and infection-related. Lymphadenopathies are followed up at 1-3-6 month intervals, and the process requires ultrasound follow-up. Our study aimed to compare the persistent and non-persistent cases. Results: In our study, lymphadenopathy cases (n=93) admitted to our pediatric haematology-oncology outpatient clinic between 2022-2023 were examined and diagnosed; reactive lymph nodes (n=76)(81. 7%), infectious mononucleosis (n=9)(9. 7%), tuberculosis (n=1)(1%), lymphoma (n=2)(2%), benign cytology (n=2)(2%). Mean age ± standard deviation (SD); 8. 2±4. 4, number of girls; 42 (45. 2%). The median time to resolution of acute (n=8)(8. 6%), subacute (n=26)(28%), chronic (n=59)(63. 4%) lymphadenopathy was 1 [5-155] week. Cases with and without ultrasonographic disappearance of lymphadenopathy were compared; the mean hemoglobin value (g/dL) (12. 7±1. 4 vs. 12. 3±1. 2, respectively) (p=0. 047) and platelet value (x10³/mm³) (334. 2±108. 012 vs. 288. 4±89. 5, respectively) (p=0. 047) were higher and the presence of hilar vascularity on ultrasonography (76% vs. 98. 1%) (p=0. 001) was LOWER in those who disappeared compared to those who did not disappear. There was no correlation between hypoechoic lymph node, indistinct border, necrosis, fatty hilus, perinodal cortical vascularity, cortical thickening, presence of lymph node in more than one region and non-loss of lymph node. Conclusion: In conclusion, it has been shown that in the presence of lymphadenopathy, elevated hemoglobin and platelets, together with the presence of hilar vascularity, may be predictive findings in the failure of the lymph node to disappear. Key words: lymphadenopathy, ultrasonography, haemoglobin, platelets, childhood

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Demographic, clinical and laboratory characteristics for differential diagnosis of peripheral lymphadenopathy (LAP) and the etiologic distribution of LAP in adults; a multicenter, nested case–control study including 1401 patients from Turkey

Cited by 3 publications

References 13 publications

Diagnostic approach of tuberculous lymphadenitis in a multicenter study

Diagnostic approach of tuberculous lymphadenitis in a multicenter study

Analysis of Diagnostic Excisional Lymph Node Biopsy Results: 12-Year Experience of a Single Center

Çocukluk çağı Kronik ve Persistan Lenfadenopatilerin Ultrason ve Laboratuvar Veriler eşliğinde Öngörülebilirliği; Bir Çocuk Hematoloji-Onkoloji Polikliniği Deneyimi

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