Level 5 Lymphadenopathy Warrants Heightened Suspicion for Clinically Significant Pathology.
We conclude that patients presenting with level 5 lymphadenopathy should be investigated with heightened clinical vigilance. Our results suggest that up to 80 % will harbour clinically significant pathology requiring further medical treatment, three quarters of which will be malignancy. We report an observational study of histological outcomes of level 5 lymph node biopsies from a regional histopathology department across 5 years. 184 subjects were identified as having a biopsy of a lymph node from the level 5 region within the study period. One hundred and fifty six cases (84.8 %) had clinically significant pathology on final histology requiring further medical treatment. Lymphoma accounted for the highest number of cases (n = 72, 39.1 %), followed by metastatic carcinoma (n = 65, 35.3 %) and granulomatous change (n = 17, 9.2 %). Gender and laterality were not shown to be independent predictors of pathology significance (p > 0.05).
Royal Surrey County Hospital NHS Trust, Egerton Road, Guildford, Surrey, GU2 7XX, UK. mjcunnane@gmail.com.
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Cunnane
Royal Surrey County Hospital NHS Trust, Egerton Road, Guildford, Surrey, GU2 7XX, UK.
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Cheung
Royal Surrey County Hospital NHS Trust, Egerton Road, Guildford, Surrey, GU2 7XX, UK.
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Moore
Royal Surrey County Hospital NHS Trust, Egerton Road, Guildford, Surrey, GU2 7XX, UK.
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di Palma
Frimley Park Hospital NHS Trust, Portsmouth Road, Frimley, Surrey, GU16 7UJ, UK.
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McCombe
Royal Surrey County Hospital NHS Trust, Egerton Road, Guildford, Surrey, GU2 7XX, UK.
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Pitkin
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D000072281:Lymphadenopathy / Q000209:etiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology; D012189:Retrospective Studies; D055815:Young Adult
Histology; Lymphoma; Malignancy; Metastatic carcinoma; Neck lump