Original scientific paper
Multifactorial analysis of non-malignant lymphadenopathies
Lj. Perić
S. Židovec-Lepej
T. Jeren
A. Vince
S. Kozić
N. Perić
Abstract
Aim: Enlargement of the lymph nodes is a frequent finding. In patients younger than 40 years, about 80 % of lymphadenopathies are non-malignant. The aim of this prospective study (n = 110 patients) was a detailed characterisation of etiology, cytomorphology and cytoimmunology of non-malignant lymphadenopaties.
Methods: Anamnestic data, clinical examination, routine hematological and biochemical methods, etiological serological diagnostics, ultrasound examination, cytological punction, polymerase chain reaction (PCR) for EBV DNA in the peripheral blood, flow cytometric immunophenotyping of peripheral blood lymphocytes.
Results: EBV infection was the cause of lymphadenopathy in 57 % of patients. Bacterial lymphadenopathy was determined in 21% of patients, toxoplasmosis in 9,1 %, tularemia in 3,6 %, mixed infection in 3,6 %, cat scratch disease in 2,7 %, and cytomegalovirus (CMV) infection in 0,9 % of patients. In patients with EBV lymphadenopathy between ages 6–18 years (58 %), the most frequent localization of lymph nodes was a submandibulary region (45 %) as well as super ficial sternomastoid nodes (41 %). The majority of patients had normal total leukocyte numbers (55 %) with lymphocytosis (81 %) and the presence of reactive lymphocytes (57 %). Elevated levels of liver enzymes were also observed: LDH (71 % of patients), AST (84 % of patients), ALT (87 % of patients). Reactive lymph nodes hyperplasia was revealed by cytological examination of lymph nodes in all patients. EBV DNA was detectable in the peripheral blood of 4 patients without serological evidence of acute infection. Flow cytometry analysis revealed increased percentages of T-cells, CD8+T-cells, HLA-DR+T-cells as well as decreased percentages of B-cells and CD4+ T-cells in the peripheral blood of EBV-infected patients compared with healthy controls.
Keywords
non-malignant lymphadenopathy – etiology; diagnosis
Hrčak ID:
12762
URI
Publication date:
30.9.2005.
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