2025 Volume 118 Issue 1 Pages 61-66
[Objective] Cervical lymphadenopathy is mostly due to inflammatory diseases such as bacterial or viral infections and autoimmune diseases, while malignant diseases such as malignant lymphomas and cancer metastasis could also be the cause. Differentiating between inflammatory diseases and malignant diseases using non-invasive tests including blood tests and fine needle aspiration cytology (FNA) is important to decide whether a lymph node biopsy is necessary or not and to determine the course of treatment. In this study, we compared the clinical and laboratory findings of patients with cervical lymphadenopathy with a focus on differentiating between inflammatory and malignant diseases.
[Subjects and methods] A total of 183 patients with enlarged cervical lymph nodes who visited our hospital over the past four years and nine months were included in this study. Patients were divided into the inflammatory group and the malignant disease group. The breakdown of diseases, age distribution, duration of illness, presence/absence of pain, serum soluble IL-2 receptor levels, and the accuracy of FNA were examined retrospectively.
[Results] There were 125 patients in the inflammatory disease group and 58 patients in the malignant disease group. The inflammatory disease group showed a lower age, shorter disease duration, and higher proportion of patients with pain than the malignant disease group. Soluble IL-2 receptor levels were higher in the malignant disease group (884.5 U/ml) than in the inflammatory disease group (510.5 U/ml). The specificity, sensitivity, and diagnostic accuracy of FNA were 78.4%, 98.8%, and 91.2%, respectively. False negative results of FNA were found in 11 cases, of which 10 were cases of malignant lymphoma.
[Conclusion] Serum soluble IL-2 receptor levels and FNA were useful for differentiating between the inflammatory and malignant disease groups. Lymph node biopsy should be performed if malignant lymphomas cannot be excluded, especially bearing in mind the limitations of non-invasive tests, even if comprehensive, in the diagnosis of malignant lymphoma.
