ArticleSouthern African journal of HIV medicine2025
The diagnostic pathway to lymph node excision biopsy in an HIV- and tuberculosis-endemic region.
Article in Southern African journal of HIV medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Point-of-care core needle biopsy pathway for early diagnosis of lymph node masses: comparative costing of a scalable pathway.Health economics review · 2026Article
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8 authors.
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Abstract
Background: In the HIV/tuberculosis endemic Western Cape public care setting, diagnostic consideration of patients with persistent lymphadenopathy focuses on extra-pulmonary tuberculosis (EPTB), delaying diagnosis of other infectious or malignant causes of lymphadenopathy. Objectives: To evaluate the diagnostic pathways of patients investigated for lymphadenopathy at Groote Schuur Hospital. Method: A retrospective review of patients undergoing lymph node excision biopsy was conducted to correlate test selection and results prior to biopsy with final patient diagnosis and assess the impact of pre-biopsy pathways on diagnostic delay. Results: Of 86 patients undergoing excision biopsy, 61 (71%) had no previous diagnosis to explain the lymphadenopathy. Extra-pulmonary tuberculosis was the commonest diagnosis (24.6%, 15/61), followed by lymphoma (21.3%, 13/61), and metastatic cancer (14.8%, 9/61). Median time from presentation with lymphadenopathy to first excision biopsy was 55 days (interquartile range [IQR] 22-106). Fine needle aspiration (FNA) cytology of lymphadenopathy was performed in 30 out of 61 (49%) of the patients and repeated in a third of these, while smear for acid-fast bacilli and culture for Conclusion: In patients with lymphadenopathy, we demonstrate how poorly structured diagnostic pathways contribute to unnecessary healthcare utilisation and diagnostic delay in treatable conditions. Providing early access to biopsy after appropriate workup ensures accurate diagnosis of unexplained lymphadenopathy.
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