Cervical lymph node extirpation for the diagnosis of malignant lymphoma

Yorihisa Orita, Soichiro Nose, Yasuharu Sato, Kentaro Miki, Shuhei Domae, Misato Hirai, Yasuyuki Noyama, Kazuo Hamaya, Norio Kasai, Kazunori Nishizaki, Tadashi Yoshino

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13 Citations (Scopus)

Abstract

Purpose: Lymph node enlargement in the neck is a common presentation of malignant lymphoma (ML) and requires tissue sampling for accurate diagnosis. Although delayed diagnosis may be critical for some patients, unnecessary biopsy should be avoided wherever possible. This study examined the process for determining the necessity to perform a biopsy and evaluated the value of an open biopsy as a diagnostic tool to enable definite subclassification of the disease. Methods: The subjects included 20 patients with suspected ML who underwent cervical lymph node extirpation at Okayama Saiseikai general hospital between 2007 and 2010. The decision to perform a biopsy was made based on the results of sonographic evaluation, fine needle aspiration cytology (FNAC), and serum levels of lactate dehydrase (LDH) and soluble interleukin-2 receptor (sIL-2r). Results: The diagnosis was ML in 15 patients (75%), Castleman's disease in 1 (5%), and benign lymphadenopathy in 4 (20%). Conclusions: A lymph node biopsy remains the gold standard for the diagnostic evaluation of ML. Sonographic evaluation combined with serum levels of LDH and sIL-2r is useful in determining the need for biopsy. Many of the cases of ML where it was difficult to determine whether a biopsy should be performed were relatively low grade and critical conditions could be avoided by close observation of the patient.

Original languageEnglish
Pages (from-to)67-72
Number of pages6
JournalSurgery today
Volume43
Issue number1
DOIs
Publication statusPublished - Jan 1 2013

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Keywords

  • Cervical lymph node
  • Diagnosis
  • Extirpation
  • Malignant lymphoma

ASJC Scopus subject areas

  • Surgery

Cite this

Orita, Y., Nose, S., Sato, Y., Miki, K., Domae, S., Hirai, M., Noyama, Y., Hamaya, K., Kasai, N., Nishizaki, K., & Yoshino, T. (2013). Cervical lymph node extirpation for the diagnosis of malignant lymphoma. Surgery today, 43(1), 67-72. https://doi.org/10.1007/s00595-012-0149-1