Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/25836
Title: Use of Ultrasonography Facilitates Noninvasive Evaluation of Lymphadenopathy in a Lymph Node Diagnostic Clinic.
Austin Authors: Loh, Zoe ;Hawkes, Eliza A ;Chionh, Fiona;Azad, Arun;Chong, Geoffrey 
Affiliation: Olivia Newton-John Cancer Research Institute
University of Melbourne, Melbourne, Australia
Department of Medical Oncology, Peter MacCallum Cancer Center, Melbourne, Australia
Medical Oncology
Eastern Health, Melbourne, Australia
University of Melbourne, Melbourne, Australia
School of Cancer Medicine, La Trobe University, Melbourne, Australia
Olivia Newton-John Cancer Wellness and Research Centre
Issue Date: Feb-2021
Date: 2020-10-02
Publication information: Clinical Lymphoma, Myeloma & Leukemia 2021; 21(2): e179-e184
Abstract: Prompt and accurate diagnosis of lymphadenopathy is important, yet there is wide variability in clinical approach and referral patterns, leading to unnecessary investigations and delays in diagnosis. To address this, a lymph node diagnostic clinic (LNDC) was established at our tertiary referral center. We retrospectively analyzed data from 320 consecutive patients referred to the LNDC from March 2008 to March 2020, to describe their management and outcomes. The most common diagnoses were reactive (57%) and malignant lymphadenopathy (28%). In those with reactive lymphadenopathy, 33% did not undergo further investigations, 37% underwent imaging only, and 29% underwent biopsy. For malignant lymphadenopathy, diagnosis was made at a median (interquartile range) of 9 (6-16) days from first LNDC review, with the decision to biopsy made at the first LNDC review in 95% of cases. Clinical features significantly associated with malignancy included age > 45, B symptoms, history of malignancy, and lymphadenopathy that was ≥ 2 cm, in multiple regions, bilateral, multiple nodes, or supraclavicular. At least 3 of these features were present in 88% of patients with malignant lymphadenopathy. Ultrasound had a sensitivity of 98% and negative predictive value of 97% for detecting malignant lymphadenopathy. A dedicated LNDC in a tertiary referral center facilitates rapid assessment and diagnosis of lymphadenopathy through a risk-stratified model of management. Ultrasonography, as well as the presence of defined clinical risk factors, were most useful to differentiate benign from malignant lymphadenopathy.
URI: https://ahro.austin.org.au/austinjspui/handle/1/25836
DOI: 10.1016/j.clml.2020.09.012
Journal: Clinical Lymphoma, Myeloma & Leukemia
PubMed URL: 33573754
Type: Journal Article
Subjects: Benign
Biopsy
Lymphoma
Malignant
Negative predictive value
Appears in Collections:Journal articles

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