Peripheral Lymphadenopathy and Infections: Evaluation of 197 Cases
Peripheral Lymphadenopathy and Infections: Evaluation of 197 Cases
Objectives: In our study, we aimed to evaluate the causes of peripheral lymphadenopathy (LAP). Materials and Methods: Patients older than 18 years old who were diagnosed with LAP and underwent peripheral lymph node biopsies between 01.11.2017 and 01.01.2020 were included in the study. The demographic data and histopathological findings of the patients were retrospectively reviewed on the computer database of the hospital. Results: One hundred ninety-seven adult patients in total were included in the study, 51.27% (n=101) of whom were female. The rates of fever, night sweats, and weight loss symptoms were detected as 8.63%, 13.70%, and 20.30%, respectively. Excisional biopsy was performed in 93.40% of the patients, and the most frequently excised lymph node was the axillary node at a rate of 40.10%. According to the results of the histopathological analyses, the most common etiology was malignancy, and the second one was infectious, at 31.98% and 29.95%, respectively. Malignancy was caused by lymphoma in 93.65% of the cases, whereas the infectious etiology was caused by tuberculosis at 74.58%. A specific diagnosis could not be made for 26.90% of the cases, and their outpatient follow-up was continued. Conclusion: Although LAP is often associated with infections, it also occurs as a manifestation of malignant diseases. In our study, the most common etiology was malignant diseases. Infections were the second most common etiology, and among infections, tuberculosis was the leading one. LAP is a frequently encountered clinical condition that is difficult to manage. To avoid delays in diagnosis, patients should be carefully evaluated and followed closely. Although a specific diagnosis cannot always be made, histopathology remains the gold standard for diagnosis.
___
- 1. Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A. Peripheral lymphadenopathy: approach and diagnostic tools. Iran J Med Sci. 2014;39(2):158-70.
- 2. Gaddey HL, Riegel AM. Unexplained Lymphadenopathy: Evaluation and Differential Diagnosis. Am Fam Physician. 2016;94(11):896-903.
- 3. Freeman AM, Matto P. Adenopathy. StatPearls, 2022 [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK513250/. (Accessed: 06.06.2022).
- 4. Weinstock MS, Patel NA, Smith LP. Pediatric Cervical Lymphadenopathy. Pediatr Rev. 2018;39(9):433-43 (doi: 10.1542/pir.2017-0249).
- 5. Lucas SB. Lymph node pathology in infectious diseases. Diagnostic Histopathology. 2017;23(9):420-30 (doi: 10.1016/j.mpdhp.2017.07.002).
- 6. Gül M, Aliosmanoğlu İ, Türkoğlu A et al. Peripheral lymphadenopathy in adults: Results of 67 cases of excisional biopsy. Dicle Medical Journal. 2013;40(2):245-49 (doi:10.5798/diclemedj.0921.2013.02.0263).
- 7. Özkan EA, Göret CC, Özdemir ZT, et al. Evaluation of peripheral lymphadenopathy with excisional biopsy: six-year experience. Int J Clin Exp Pathol. 2015;8(11):15234-9.
- 8. Mabedi C, Kendig C, Liomba G, et al. Causes of cervical lymphadenopathy at Kamuzu Central Hospital. Malawi Med J. 2014;26(1):16-9.
- 9. Çetinkaya RA, İlbak A, Yenilmez E. Etiology in Patients Presenting with Lymphadenopathy; Approach From the Perspective of Infectious Diseases. İKSSTD. 2019; 11(3):149-56 (doi:10.5222/iksstd.2019.66375).
- 10. Yenilmez E, Verdi Y, Ilbak A, et al. 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. Intern Emerg Med. 2021;16(8):2139-53 (doi: 10.1007/s11739-021-02683-2).
- 11. Natarajan A, Beena PM, Devnikar AV, Mali S. A systemic review on tuberculosis. Indian J Tuberc. 2020;67(3):295-311(doi: 10.1016/j.ijtb.2020.02.005).
- 12. Türkiye’de Verem Savaş 2020 Raporu. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü Tüberküloz Daire Başkanlığı, 2020 [Internet]. https://hsgm.saglik.gov.tr/tr/tuberkuloz-haberler/turkiye-de-verem- savasi.html. (Accessed: 02.06.2022).
- 13. Sunnetcioglu M, Baran AI, Binici I, Esmer F, Gultepe B. Evaluation of 257 extra pulmonary tuberculosis cases at the Tuberculosis Control Dispensary, Van, Turkey. J Pak Med Assoc. 2018; 68(5):764-7.
- 14. Olu-Eddo AN, Ohanaka CE. Peripheral lymphadenopathy in Nigerian adults. J Pak Med Assoc. 2006;56(9):405-8.
- 15. Shrestha AL, Shrestha P. Peripheral Lymph Node Excisional Biopsy: Yield, Relevance, and Outcomes in a Remote Surgical Setup. Surg Res Pract. 2018; 2018:8120390 (doi: 10.1155/2018/8120390).
- 16. Bruchfeld J, Correia-Neves M, Källenius G. Tuberculosis and HIV Coinfection. Cold Spring Harb Perspect Med. 2015; 5(7): a017871(doi: 10.1101/cshperspect.a 017871).
- 17. Tuberculosis. WHO, 2022 [Internet]. https://www.who.int/health-topics/tuberculosis#tab=tab_1. (Accessed: 03.06.2022).
- 18. Latent tuberculosis. EACS, 2021 [Internet]. https://www.eacsociety.org/guidelines/eacs-guidelines. (Accessed: 04.06.2022).
- 19. Zangwill KM. Cat Scratch Disease and Bartonellaceae: The Known, the Unknown and the Curious. Pediatr Infect Dis J. 2021;40(5S):11-5 (doi: 10.1097/INF.0000000000002776).
- 20. Baranowski K, Huang B. Cat Scratch Disease. StatPearls, 2022 [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK482139/. (Accessed: 04.06.2022).
- 21. Dunmire SK, Verghese PS, Balfour HH Jr. Primary Epstein-Barr virus infection. J Clin Virol. 2018; 102:84- 92 (doi: 10.1016/j.jcv.2018.03.001).
- 22. Naughton P, Healy M, Enright F, Lucey B. Infectious Mononucleosis: diagnosis and clinical interpretation. Br J Biomed Sci. 2021;78(3):107-16 (doi: 10.1080/09674845.2021.1903683).
- 23. Ferrer R. Lymphadenopathy: differential diagnosis and evaluation. Am Fam Physician. 1998; 58(6):1313- 20.
- 24. Prudent E, La Scola B, Drancourt M, Angelakis E, Raoult D. Molecular strategy for the diagnosis of infectious lymphadenitis. Eur J Clin Microbiol Infect Dis. 2018;37(6):1179-86 (doi: 10.1007/s10096-018-3238-2).