Acta clinica Croatica, Vol. 62. No. 1, 2023.
Izvorni znanstveni članak
https://doi.org/10.20471/acc.2023.62.01.07
Analysis of Diagnostic Excisional Lymph Node Biopsy Results: 12-Year Experience of a Single Center
Zulfu Bayhan
orcid.org/0000-0002-7587-7267
; Sakarya University Faculty of Medicine, Department of General Surgery, Sakarya, Turkey
Kayhan Ozdemir
; Sakarya Research and Educational Hospital, Department of General Surgery, Sakarya, Turkey
Emre Gonullu
; Sakarya Research and Educational Hospital, Department of Gastrointestinal Surgery, Sakarya, Turkey
Ahmet Tarik Harmantepe
; Sakarya Research and Educational Hospital, Department of General Surgery, Sakarya, Turkey
Recayi Capoglu
; Sakarya Research and Educational Hospital, Department of General Surgery, Sakarya, Turkey
Emrah Akin
; Sakarya Research and Educational Hospital, Department of General Surgery, Sakarya, Turkey
Mehmet Aziret
; Sakarya Research and Educational Hospital, Department of Gastrointestinal Surgery, Sakarya, Turkey
Fatih Altintoprak
; Sakarya University Faculty of Medicine, Department of General Surgery, Sakarya, Turkey
Sažetak
Lymph node biopsy is indicated in patients with suspected malignancy or lymphadenopathy
due to unclarified reasons. Lymph node biopsy can be performed as fine needle aspiration
biopsy, core biopsy, or excisional lymph node biopsy. In particular, the diagnosis of malignant lymphoma
is considered insufficient for oncological treatment unless classified into subgroups. Core biopsy and excisional
biopsy can be performed to diagnose lymphoma and classify it into subgroups. Core biopsy may
also be limited in some cases for the diagnosis of lymphoma. Therefore, patients are referred to surgical
departments for excisional lymph node biopsy. It was aimed herein to analyze the results of excisional
lymph node biopsies performed for diagnostic purposes in our department. Data on 73 patients having
undergone diagnostic excisional lymph node biopsy at Sakarya University Medical Faculty Training and
Research Hospital between January 2008 and January 2020 were retrospectively analyzed. Patients were
evaluated in terms of age, gender, biopsy site, pathological diagnosis, number and diameter of lymph
nodes excised. Patients younger than 18 years of age, those with sentinel lymph node biopsies, and lymph
node dissections performed for any known malignancy were excluded from the study. Statistical data
analysis was done using SPSS statistical software. There were 37 (50.7%) female and 36 (49.3%) male
patients, mean age 52.07 (18-90) years. Axillary lymph node biopsy was performed in 32 patients, inguinal
lymph node biopsy in 29 patients, cervical lymph node biopsy in 3 patients, intra-abdominal lymph
node biopsy in 6 patients, mediastinal lymph node biopsy in 1 patient, and supraclavicular lymph node
biopsy in 2 patients. All of the lymph node biopsies were performed as excisional biopsy. Malignancy
was detected in 36 (49.3%) patients. In 37 (50.3%) patients, the causes of lymphadenopathy were found
to be benign pathologies. When the causes of malignant disease were examined, it was observed that 23
(31.5%) patients were diagnosed with lymphoma. Hodgkin lymphoma was detected in 5 patients diagnosed
with lymphoma, and non-Hodgkin lymphoma was found in 18 patients. Metastatic lymphadenopathy
was observed in 13 (17.8%) patients. Reactive lymphoid hyperplasia (26%) and lymphadenitis
(20.5%) were found among the causes of benign lymphadenopathy. The number of excised lymph nodes
was between 1 and 4, and their diameter was between 9 and 75 mm (mean: 29.53±15.56 mm). There was
no statistically significant difference between benign and malignant patients according to gender, age,
lymph node diameter, number of lymph nodes excised, and excisional lymph node biopsy site. For diagnostic
lymph node biopsy, fine-needle aspiration biopsy and core biopsy should be performed primarily.
If lymphoma is suspected in the diagnosis, fine-needle aspiration biopsy is not necessary. In this case, it
is believed that it is more appropriate to perform core biopsy first. If the core biopsy is insufficient for
diagnosis, it is more appropriate to perform surgical biopsy in order to cause no delay in diagnosis and
treatment. Excisional biopsy is a method that can be safely performed and does not cause severe morbidity
in palpable peripheral lymphadenopathies. Although it does not cause severe morbidity because it is
an invasive procedure, excisional biopsy should be performed in a selected patient group.
Ključne riječi
Lymphadenopathy; Excisional biopsy; Lymphoma; Reactive lymphoid hyperplasia; Lymphadenitis
Hrčak ID:
307163
URI
Datum izdavanja:
1.4.2023.
Posjeta: 477 *