To the Editor.—
The article concerning the diagnosis of lymphadenopathy in primary care practice by Sheldon Greenfield, MD, and M. Colin Jordan, MD (240:1388, 1978), correctly states that in the workup of persistent enlarged lymph nodes, "after local lesions have been effectively excluded, other systemic conditions must be pursued by biopsy of the enlarged node."Head and neck surgeons have found through experience that "partial surgical removal of a mass for diagnostic purposes is always objectionable and should be avoided if there is any alternative procedure."1 This was convincingly reaffirmed by McGuirt and McCabe,2 who retrospectively analyzed the data from 64 patients who had had a cervical node biopsy before diagnosis and definitive treatment. The complications of wound necrosis and local cervical recurrence were substantially higher in these patients than in those who had had either no cervical node biopsy or a node biopsy only at the time
Browder JP. Biopsy of Cervical Node. JAMA. 1979;241(6):565–566. doi:10.1001/jama.1979.03290320013015
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