Clinical Characteristics of Patients with Malignancy in Cervical Lymph Node Biopsies

Abstract

Background: Cervical lymphadenopathy has a number of causes, including malignancies such as lymphoma and metastatic tumors. Accurate differentiation between patients with benign or malignant disease is crucial for appropriate management.

Methods: Forty patients who underwent cervical lymph node biopsy were included. Patients were classified into malignant (n = 19) or non-malignant (n = 21) groups based on the histopathological diagnosis. The clinical course, blood test results, imaging findings, and fine-needle aspiration cytology (FNAC) classifications were compared.

Results: Patients in the malignant group were significantly older (median, 72 years vs. 50 years, p < 0.01) and had shorter duration of symptoms (median, 30 days vs. 90 days, p = 0.02). Serum lactate dehydrogenase (LDH) and soluble interleukin 2 receptor (sIL-2R) levels were higher in the malignant group, with cutoff values of 217 IU/L and 589 U/mL, respectively. Imaging findings alone were insufficient for accurate diagnosis. All patients with Class IV and V FNAC results were diagnosed with malignancy, and Class III and higher were significantly associated with malignancy.

Conclusions: Age, duration of symptoms, LDH and sIL-2R levels, and FNAC classification are useful indicators for differentiating malignant cervical lymphadenopathy. A comprehensive evaluation combining these factors is essential for an accurate diagnosis, as imaging alone is unreliable.