![]() The possibility of malignancy raises the most concern among patients and health care professionals. When physicians are faced with these patients, the critical tasks are to differentiate benign from malignant lymph nodes, to identify serious medical conditions that require specialist care, and to reassure patients with benign reactive lymphadenopathy or self-limiting diseases. Patients with lymphadenopathy present to a wide range of medical specialties. ![]() An annual incidence of 0.6–0.7% has been estimated for the general population ( Allhiser et al, 1981 Fijten and Blijham, 1988). Lymphadenopathy (LA) is common and affects patients of all ages. 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. An accuracy of 97 and 84% was found, respectively. Ultrasound and fine-needle aspiration cytology of palpable lymph nodes were performed in 154 and 289 patients, respectively. 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 ⩾2 regions of lymph nodes (RR=6.41 95% CI: 2.82–14.58). Of 95 patients diagnosed to have malignant diseases, the median time from the first clinic visit to reaching malignant diagnosis was 15 days. The median time between initial referral and the first clinic visit was 6 days. The median age was 40 years (range 14–90). Between December 1996 and July 2001, 550 patients were referred (M: 203 F:347). ![]() ![]() Details of clinical presentation and investigations were recorded prospectively. Our institution set up a lymph node diagnostic clinic (LNDC) accepting direct referrals from primary care physicians. The current referral pattern for investigating patients with lymphadenopathy varies widely with no universally practised pathway. Lymphadenopathy is common, affecting patients of all ages. ![]()
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