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Yenilmez E, Verdi Y, Ilbak A, Demirkiran BC, Duman Z, Bozkurt F, Seyman D, Asan A, Eker HBS, Ceylan MR, Emre S, Altunyurt GO, Ayan S, Parlak E, Toros GY, Yoruk G, Ceylan M, Karaagac L, Ozguler M, Meral B, Ay M, Ozturk C, Karacaer Z, Tural E, Cetinkaya RA, Dokmetas I, Kose S. Demographic, clinical and laboratory characteristics for differential diagnosis of peripheral lymphadenopathy (LAP) and the etiologic distribution of LAP in adults; a multicenter, nested case-control study including 1401 patients from Turkey. Intern Emerg Med 2021; 16:2139-2153. [PMID: 33728579 DOI: 10.1007/s11739-021-02683-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/19/2021] [Indexed: 10/21/2022]
Abstract
Peripheral lymphadenopathy (LAP) is an important and common abnormal finding of the physical exam in general medical practice. We aimed to reveal the LAP etiology and demographic, clinical and laboratory variables that may be useful in the differential evaluation of LAP. This multicenter, nested case-control study including 1401 patients between 2014 and 2019 was conducted in 19 tertiary teaching and research hospitals from different regions in Turkey. The ratio of infectious, malign and autoimmune/inflammatory diseases was 31.3%, 5% and 0.3%, respectively. In 870 (62%) of patients had nonspecific etiology. Extrapulmonary tuberculosis (n: 235, 16.8%) was the most frequent cause of LAP. The ratio of infective etiology of LAP was significantly lower in patients older than 65 years-old compared to younger patients with the rate of 66.67% and 83.84%, respectively (p 0.016, OR 0.386, 95% Cl 0.186-0.803). The probability of malign etiology was higher both in patients who are older than 45 years-old (p < 0.001, OR 3.23, 95% Cl 1.99-5.26) and older than 65 years-old (p 0.002, OR 3.36, 95% Cl 1.69-6.68). Age, localization and duration of LAP, leukocytosis, anemia, thrombocytopenia, CRP and sedimentation rate were important parameters to differentiate infections. Size of lymph node and splenomegaly in addition to the parameters above were useful parameters for differentiating malign from benign etiology. Despite the improvements in diagnostic tools, reaching a definite differential diagnosis of lymphadenopathy is still challenging. Our results may help clinicians to decide in which cases they need an aggressive workup and set strategies on optimizing the diagnostic approach of adulthood lymphadenopathy.
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Affiliation(s)
- Ercan Yenilmez
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, 34668, Uskudar, Istanbul, Turkey.
| | - Yıldız Verdi
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ayca Ilbak
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, 34668, Uskudar, Istanbul, Turkey
| | - Burcu Caliskan Demirkiran
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Zehra Duman
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Fatma Bozkurt
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Derya Seyman
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ali Asan
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Halime Betul Sahin Eker
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Adana City Hospital, Adana, Turkey
| | - Mehmet Resat Ceylan
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Harran University, Sanliurfa, Turkey
| | - Salih Emre
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Prof. Dr. Cemil Tascıoglu City Hospital, Istanbul, Turkey
| | - Gozde Ozturk Altunyurt
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Kartal Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Saliha Ayan
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Emine Parlak
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ataturk University, Erzurum, Turkey
| | - Goknur Yapar Toros
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Ankara Onkoloji Training and Research Hospital, Ankara, Turkey
| | - Gulsen Yoruk
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, İstanbul Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Ceylan
- Department of Infectious Diseases and Clinical Microbiology, Bakircay University, Cigli Training and Research Hospital, Izmir, Turkey
| | - Leman Karaagac
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey
| | - Muge Ozguler
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Fethi Sekin City Hospital, Elazığ, Turkey
| | - Busra Meral
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Muzeyyen Ay
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Cinar Ozturk
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Zehra Karacaer
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Ersin Tural
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, 34668, Uskudar, Istanbul, Turkey
| | - Rıza Aytac Cetinkaya
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, 34668, Uskudar, Istanbul, Turkey
| | - Ilyas Dokmetas
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Sukran Kose
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
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Fabian E, Schneeweiss B, Valentin T, Flick H, Aigelsreiter A, Hofmann-Wellenhof R, Cerroni L, Goritschan AM, Brezinsek HP, Zitta S, Rosenkranz A, Graninger W, Krejs GJ. Clinical-Pathological Conference Series from the Medical University of Graz : Case No 162: A 30-year-old woman from Nigeria with fever 3 months postpartum. Wien Klin Wochenschr 2017; 129:145-152. [PMID: 28120106 PMCID: PMC5318465 DOI: 10.1007/s00508-016-1164-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 12/19/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Elisabeth Fabian
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Bruno Schneeweiss
- Department of Internal Medicine, Hospital Kirchdorf on the Krems, Kirchdorf on the Krems, Austria
| | - Thomas Valentin
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Holger Flick
- Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | | | | | - Lorenzo Cerroni
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - Anna Maria Goritschan
- Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Hans-Peter Brezinsek
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Sabine Zitta
- Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Alexander Rosenkranz
- Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Winfried Graninger
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Guenter J Krejs
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
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England CG, Rui L, Cai W. Lymphoma: current status of clinical and preclinical imaging with radiolabeled antibodies. Eur J Nucl Med Mol Imaging 2016; 44:517-532. [PMID: 27844106 DOI: 10.1007/s00259-016-3560-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 10/25/2016] [Indexed: 12/22/2022]
Abstract
Lymphoma is a complex disease that arises from cells of the immune system with an intricate pathology. While lymphoma may be classified as Hodgkin or non-Hodgkin, each type of tumor is genetically and phenotypically different and highly invasive tissue biopsies are the only method to investigate these differences. Noninvasive imaging strategies, such as immunoPET, can provide a vital insight into disease staging, monitoring treatment response in patients, and dose planning in radioimmunotherapy. ImmunoPET imaging with radiolabeled antibody-based tracers may also assist physicians in optimizing treatment strategies and enhancing patient stratification. Currently, there are two common biomarkers for molecular imaging of lymphoma, CD20 and CD30, both of which have been considered for investigation in preclinical imaging studies. In this review, we examine the current status of both preclinical and clinical imaging of lymphoma using radiolabeled antibodies. Additionally, we briefly investigate the role of radiolabeled antibodies in lymphoma therapy. As radiolabeled antibodies play critical roles in both imaging and therapy of lymphoma, the development of novel antibodies and the discovery of new biomarkers may greatly affect lymphoma imaging and therapy in the future.
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Affiliation(s)
- Christopher G England
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
| | - Lixin Rui
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Weibo Cai
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Room 7137, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
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