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Initial work-up for cervical lymphadenopathy: back to basics

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Abstract

The aim of this study was to evaluate the value of FNA, Tb-PCR, and CBC as an initial work-up protocol for cervical lymphadenopathy to reiterate the importance of CBC in terms of predicting the clinical course. In this consecutive case series, 158 patients with cervical lymphadenopathy were enrolled. All patients underwent FNA and CBC, with or without Tb-PCR. The validity of combined FNA ± Tb-PCR and CBC in the diagnosis of diseases requiring definitive treatment was evaluated. Final diagnoses were self-limiting disease in 110 (69.6%), malignancy in 19 (12.0%), and tuberculosis in 26 (16.5%). Sensitivity of FNA ± Tb-PCR was 66.7% and of added CBC profile was 97.9%. Patients with neutropenia or lymphocytosis were found to have a higher chance of spontaneous recovery than patients with a normal WBC profile. FNA and Tb-PCR were found to be important in patients aged more than 20. The results indicate that FNA, Tb-PCR, and CBC are basic and essential in initial work-up for cervical lymphadenopathy. In particular, CBC was found to aid in detecting critical diseases and predicting the likelihood of open biopsy in patients with negative FNA and Tb-PCR. Patient age was also found to be an important determinant of the work-up protocol.

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Conflict of interest

The authors declare that they have no vested interest that could be construed to have inappropriately influenced this study.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head & Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam, 463-707, Korea

    Woo-Jin Jeong, Min-Woo Park, Sung Joon Park & Soon-Hyun Ahn

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  1. Woo-Jin Jeong
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  2. Min-Woo Park
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Correspondence to Soon-Hyun Ahn.

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Jeong, WJ., Park, MW., Park, S.J. et al. Initial work-up for cervical lymphadenopathy: back to basics. Eur Arch Otorhinolaryngol 269, 2255–2263 (2012). https://doi.org/10.1007/s00405-011-1895-1

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  • DOI: https://doi.org/10.1007/s00405-011-1895-1

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