Evaluation of the patient with lymphadenopathy: Is it always easy to reach the correct diagnosis?

Abstract

Lymphadenopathy (LAP) is a common clinical problem in adult patients and should be thoroughly evaluated in a tertiary hospital to investigate its reasons. In this study, we aimed to present the demographic characteristics, etiology, diagnosis and follow-up results of the patients who applied with LAP symptoms and findings. This study was designed to include adult patients with neck, armpit, or groin swelling accompanied by symptoms, such as fever, night sweats, weight loss, cough and sputum between January 2010 and August 2017, retrospectively. Patients’ data were collected from electronic files. Patients were diagnosed using radiological, histopathological, bacteriological, serological and other microbiological methods. Two hundred-thirty patients were included in this study. The mean age was 43.12±17.06 SD in males and 45.74±16.64 in females. On admission, the most common symptoms were night sweats (31%), fever (23%), weight loss (17%) and cough and/or sputum (13%) in order of frequency. However, 16% of the patients were asymptomatic. In this study, 157 (68.26%) patients were diagnosed. Tuberculosis (n=76; 33%), malignancies (n=28, 12.1%) and tularemia (N=14; 6.1%) were the most common diseases causing LAP that was most commonly located in the bilateral cervical chain. Lymphadenopathy should be evaluated comprehensively concerning diagnosing or ruling out many diseases that must be treated necessarily. Knowledge and awareness of the diseases as a cause of LAP may contribute to the early and correct diagnosis. Therefore, undiagnosed patients should be followed, and the institutions should develop policies for this purpose, such as telemedicine applications.

Key words: Lymphadenopathy in adults, infectious diseases, diagnosis