Predicting Malignancy in Peripheral Lymphadenopathy

Soldes and colleagues reviewed records of 60 consecutive University of Michigan patients referred for peripheral lymph node biopsy to identify factors that predict malignancy. Fifteen patients were excluded because of a prior diagnosis of cancer or a fluctuant node, leaving 45 patients for final analysis. Increasing risk was found to be associated with larger nodes (greater than 2 cm, Odds Ratio [OR]* 5.8), more than 2 sites of adenopathy (OR*=7.8) and older age (mean age of 12 years for malignant nodes versus 6 years for benign). Additional factors associated with a greater chance of malignancy included supraclavicular adenopathy (OR=10.9), adenopathy on chest x-ray (OR=12.8) and fixed lymph nodes (OR=11.5). The authors found no difference …