Cervical Lymph Node Excision – A Retrospective Analysis of Differential Diagnoses and Prognostic Variables

Christian Rohrmeier, Tobias Ettl, Fischer René and Thomas S Kuehnel

Department of Medicine, University of Regensburg, Germany
Department of Otorhinolaryngology, University of Regensburg, Germany
Department of Oral and Maxillofacial Surgery, University of Regensburg, Germany

^*Correspondance to: Christian Rohrmeier 

 PDF  Full Text DOI: 10.25107/2474-1647.2181

Abstract

Background: Lymphadenopathy often poses problems in terms of differential diagnosis. Lymph node excision is therefore frequently a necessary component in diagnostic work-up and confirmation. Current data are scarce concerning diagnostic frequency distributions and prognostic variables for this routine procedure in otorhinolaryngology.Methods: All lymph node excisions conducted here between 01/2007 and 12/2011 were analyzed retrospectively. Exclusion criteria were previously known lymphomas or carcinomas in the head and neck region and peripheral malignomas if patients had not been recurrence-free for 5 years.Results: The analysis included 175 patients (mean age: 40.0 years; 1-94), of whom 46.3% were female. Histology revealed reactive changes in 45.7% and specific changes in 11.4%, lymphomas in 29.7%, metastases in 5.1%, and other tumors in 8.0%. Malignant findings were recorded in 82.4% of cases of supraclavicular lymphadenopathy. Abnormal laboratory variables (p<0.01) were encountered significantly less frequently in reactive lymph node changes, B symptoms significantly more frequently in lymphomas (p<0.01) and nicotine and alcohol abuse in metastases (p<0.01). No significant differences were found for gender. The complication rate was 2.3%.Conclusion: In just over 46% of cases lymph node histology revealed findings that required treatment, and in 75% of these the findings were malignant. Given the minimal surgical risk, lymph node excision should be performed at an early stage where the diagnosis is uncertain so that specific therapy can be initiated early. Location, laboratory variables and B symptoms may provide pointers to specific or malignant pathology.

Keywords

Cervical lymph nodes; Excision; Specific lymphadenitis; Lymphoma; Malignoma

Cite the article

Rohrmeier C, Ettl T, René F, Kuehnel TS. Cervical Lymph Node Excision – A Retrospective Analysis of Differential Diagnoses and Prognostic Variables. Clin Surg. 2018; 3: 2181.