Predictors of the necessity for lymph node biopsy of cervical lymphadenopathy

Purpose: Enlargement of cervical lymph nodes is required for early and accurate diagnosis of malignant lymphoma (ML). Lymph node biopsy is still indispensable for accurate diagnosis of lymph node enlargement in the lateral neck. Material and methods: We retrospectively investigated the characteristics of lymph nodes on both ultrasonography (US) and computed tomography (Cr), and blood biomarkers including serum thymidine kinase (TK) and soluble interleukin-2 receptor (sIL-2R) in 19 patients who underwent cervical lymph node biopsy. Results: Pathological diagnosis was ML in 8 patients, reactive lymphadenopathy (RL) in 8, and purulent lymphadenitis (PL) in 3. TK levels were significantly higher in patients with ML than in patients with RL, demonstrating positive correlations with sIL-2R and lymph node size on CT image. The shape of lymph nodes on US in all of the 8 patients diagnosed with RL was flat, whereas the shape in 7 of 8 patients diagnosed with ML was round. Lymph node size >19.5 mm at an axial section on Cl' image was used as a cut-off value to differentiate ML from other pathologies, offering 90.9% sensitivity and 87.5% specificity. Conclusion: Sonographic and CT evaluation combined with high TK level might be useful in determining the need for early biopsy. 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.