Baseline characteristics predictive of malignancy among patients presenting with lymphadenopathy: A cancer center experience

2013 
Context: Patients who present to tertiary cancer centers solely with radiologic evidence of lymphadenopathy often are diagnosed with malignancy, but it is unclear which baseline characteristics are predictive of a cancer diagnosis. Materials and Methods: We conducted a retrospective data review to determine baseline characteristics predictive of a cancer diagnosis and the optimal follow-up time for such patients. Results: Sixty-six adult patients with lymphadenopathy were evaluated. Thirty-six patients (55%) were diagnosed with cancer; the most common type was lymphoma. Cancer was diagnosed in 94%, 79%, and 70% of patients with supraclavicular, retroperitoneal, and abdominal lymphadenopathy, respectively. Increasing age and hypertension were associated with a cancer diagnosis in the multivariate analysis. The mean time to diagnosis was 15 days (range, 1-140 days). The average follow-up time was 18 months in patients without a cancer diagnosis. Conclusions: Patients presenting solely with lymphadenopathy at a cancer center have a higher likelihood of being diagnosed with cancer if they are at least 50 years old or have hypertension. Supraclavicular lymphadenopathy is highly associated with a malignant diagnosis. We suggest that patients presenting solely with lymphadenopathy should be followed-up for at least 6 months for a definitive diagnosis.
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