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Rapid access multidisciplinary lymph node diagnostic clinic: analysis of 550 patients.

Chau I, Kelleher MT, Cunningham D, Norman AR, Wotherspoon A, Trott P, Rhys-Evans P, Querci Della Rovere G, Brown G, Allen M, Waters JS, Haque S, Murray T, Bishop L - Br. J. Cancer (2003)

Bottom Line: Ultrasound and fine-needle aspiration cytology of palpable lymph nodes were performed in 154 and 289 patients, respectively.An accuracy of 97 and 84% was found, respectively.In conclusion, a multidisciplinary lymph node diagnostic clinic enables a rapid, concerted approach to a common medical problem and patients with malignant diseases were diagnosed in a timely fashion.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Royal Marsden Hospital, Surrey, UK.

ABSTRACT
Lymphadenopathy is common, affecting patients of all ages. The current referral pattern for investigating patients with lymphadenopathy varies widely with no universally practised pathway. Our institution set up a lymph node diagnostic clinic (LNDC) accepting direct referrals from primary care physicians. Details of clinical presentation and investigations were recorded prospectively. Between December 1996 and July 2001, 550 patients were referred (M: 203; F:347). The median age was 40 years (range 14-90). The median time between initial referral and the first clinic visit was 6 days. Of 95 patients diagnosed to have malignant diseases, the median time from the first clinic visit to reaching malignant diagnosis was 15 days. Multivariate logistic regression analysis identified five significant predictors for malignant nodes: male gender (risk ratio (RR)=2.72; 95% confidence interval (CI): 1.63-4.56), increasing age (RR=1.05; 95% CI: 1.04-1.07), white ethnicity (RR=3.01; 95% CI: 1.19-7.6) and sites of lymph nodes: supraclavicular region (RR=3.72; 95% CI: 1.52-9.12) and > or = 2 regions of lymph nodes (RR=6.41; 95% CI: 2.82-14.58). Ultrasound and fine-needle aspiration cytology of palpable lymph nodes were performed in 154 and 289 patients, respectively. An accuracy of 97 and 84% was found, respectively. In conclusion, a multidisciplinary lymph node diagnostic clinic enables a rapid, concerted approach to a common medical problem and patients with malignant diseases were diagnosed in a timely fashion.

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Time period from referral to diagnosis for the whole study cohort and treatment for Hodgkin's disease (HD) and diffuse large B-cell non-Hodgkin's lymphoma (DLBCL). Median, range and interquantile range are quoted. As median values are quoted, time point G does not equal the sum of the median values of A and C and E. Similarly, time point H does not equal the sum of the median values of time points A and D and F.
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fig1: Time period from referral to diagnosis for the whole study cohort and treatment for Hodgkin's disease (HD) and diffuse large B-cell non-Hodgkin's lymphoma (DLBCL). Median, range and interquantile range are quoted. As median values are quoted, time point G does not equal the sum of the median values of A and C and E. Similarly, time point H does not equal the sum of the median values of time points A and D and F.

Mentions: Between December 1996 and July 2001, 550 patients were referred to the lymph node diagnostic clinic. Table 2 shows the baseline demographics of the patients referred. The median age was 40 years (range 14–90). Each general practice referred a median of two patients (range 1–25). Figure 1Figure 1


Rapid access multidisciplinary lymph node diagnostic clinic: analysis of 550 patients.

Chau I, Kelleher MT, Cunningham D, Norman AR, Wotherspoon A, Trott P, Rhys-Evans P, Querci Della Rovere G, Brown G, Allen M, Waters JS, Haque S, Murray T, Bishop L - Br. J. Cancer (2003)

Time period from referral to diagnosis for the whole study cohort and treatment for Hodgkin's disease (HD) and diffuse large B-cell non-Hodgkin's lymphoma (DLBCL). Median, range and interquantile range are quoted. As median values are quoted, time point G does not equal the sum of the median values of A and C and E. Similarly, time point H does not equal the sum of the median values of time points A and D and F.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2747551&req=5

fig1: Time period from referral to diagnosis for the whole study cohort and treatment for Hodgkin's disease (HD) and diffuse large B-cell non-Hodgkin's lymphoma (DLBCL). Median, range and interquantile range are quoted. As median values are quoted, time point G does not equal the sum of the median values of A and C and E. Similarly, time point H does not equal the sum of the median values of time points A and D and F.
Mentions: Between December 1996 and July 2001, 550 patients were referred to the lymph node diagnostic clinic. Table 2 shows the baseline demographics of the patients referred. The median age was 40 years (range 14–90). Each general practice referred a median of two patients (range 1–25). Figure 1Figure 1

Bottom Line: Ultrasound and fine-needle aspiration cytology of palpable lymph nodes were performed in 154 and 289 patients, respectively.An accuracy of 97 and 84% was found, respectively.In conclusion, a multidisciplinary lymph node diagnostic clinic enables a rapid, concerted approach to a common medical problem and patients with malignant diseases were diagnosed in a timely fashion.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Royal Marsden Hospital, Surrey, UK.

ABSTRACT
Lymphadenopathy is common, affecting patients of all ages. The current referral pattern for investigating patients with lymphadenopathy varies widely with no universally practised pathway. Our institution set up a lymph node diagnostic clinic (LNDC) accepting direct referrals from primary care physicians. Details of clinical presentation and investigations were recorded prospectively. Between December 1996 and July 2001, 550 patients were referred (M: 203; F:347). The median age was 40 years (range 14-90). The median time between initial referral and the first clinic visit was 6 days. Of 95 patients diagnosed to have malignant diseases, the median time from the first clinic visit to reaching malignant diagnosis was 15 days. Multivariate logistic regression analysis identified five significant predictors for malignant nodes: male gender (risk ratio (RR)=2.72; 95% confidence interval (CI): 1.63-4.56), increasing age (RR=1.05; 95% CI: 1.04-1.07), white ethnicity (RR=3.01; 95% CI: 1.19-7.6) and sites of lymph nodes: supraclavicular region (RR=3.72; 95% CI: 1.52-9.12) and > or = 2 regions of lymph nodes (RR=6.41; 95% CI: 2.82-14.58). Ultrasound and fine-needle aspiration cytology of palpable lymph nodes were performed in 154 and 289 patients, respectively. An accuracy of 97 and 84% was found, respectively. In conclusion, a multidisciplinary lymph node diagnostic clinic enables a rapid, concerted approach to a common medical problem and patients with malignant diseases were diagnosed in a timely fashion.

Show MeSH
Related in: MedlinePlus