title: Predictors of the necessity for lymph node biopsy of cervical lymphadenopathy.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  We retrospectively investigated the characteristics of lymph nodes on both ultrasonography (US) and computed tomography (CT), 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 CT image was used as a cut-off value to differentiate ML from other pathologies, offering 90.9% sensitivity and 87.5% specificity.
  
  
  CONCLUSIONS
  Sonographic and CT evaluation combined with high TK level might be useful in determining the need for early biopsy.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Saiseikai Matsusaka General Hospital, 15-6 Asahimachi 1-ku, Matsusaka City, Mie, 515-8557, Japan; First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita City, Osaka, 565-0871, Japan. Electronic address: g2787b@dent.osaka-u.ac.jp.
authors.forename: Tadataka
authors.initials: T
authors.lastname: Tsuji
authors.affiliation: Department of Oral and Maxillofacial Surgery, Saiseikai Matsusaka General Hospital, 15-6 Asahimachi 1-ku, Matsusaka City, Mie, 515-8557, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Satoh
authors.affiliation: Department of Pathology, Saiseikai Matsusaka General Hospital, 15-6 Asahimachi 1-ku, Matsusaka City, Mie, 515-8557, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakano
authors.affiliation: Department of Radiology, Saiseikai Matsusaka General Hospital, 15-6 Asahimachi 1-ku, Matsusaka City, Mie, 515-8557, Japan.
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Nishide
authors.affiliation: Department of Hematology and Oncology, Saiseikai Matsusaka General Hospital, 15-6 Asahimachi 1-ku, Matsusaka City, Mie, 515-8557, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Uemura
authors.affiliation: First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
authors.forename: Mikihiko
authors.initials: M
authors.lastname: Kogo
mesh_terms: D001706:Biopsy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D000072281:Lymphadenopathy / Q000175:diagnosis*; D008206:Lymphatic Diseases
keywords: Biopsy; Blood biomarker; CT image; Cervical lymph node; Malignant lymphoma; Ultrasonography