Lymphadenopathy for investigation
Emergency referrals
All urgent cases must be discussed with the on call Haematology registrar or after hours the on call consultant. Contact through Royal Brisbane and Women's Hospital switch (07) 3646 8111 or The Prince Charles Hospital switch on (07) 3139 4000 to obtain appropriate prioritisation and treatment.
Urgent cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Central Patient Intake Unit: 1300 364 952.
Does your patient wish to be referred?
Minimum referral criteria
Does your patient meet the minimum referral criteria?
Category 1
Appointment within 30 days is desirable
- Abnormal lymph node detected clinically or via imaging – and not biopsied (or inconclusive biopsy). For optimum care, patient should be seen within 2 weeks.
- And IF ANY of the following are present (for optimum care, patient should be seen within 2 weeks):
- symptomatic lymphadenopathy
- raised LDH
- bulky disease (> 7cm diameter of LN mass)
- presence of fever, night sweats, weight loss or new onset pruritus
- concurrent recent onset cytopenias (e.g. anaemia, thrombocytopenia)
- extranodal masses
- clinical history of rapid growth
- And IF ALL the following are present:
- asymptomatic or minimally symptomatic lymphadenopathy
- normal FBC and stable creatinine and liver function
- clinical history of slow growth
- non bulky disease
- clinically well (absence of the following – fever, night sweats, weight loss or pruritus)
Category 2
Appointment within 90 days is desirable
- No category 2 criteria
Category 3
Appointment within 365 days is desirable
- No category 3 criteria
If your patient does not meet the minimum referral criteria
Consider other treatment pathways or an alternative diagnosis.
If you still need to refer your patient:
- Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
- Please note that your referral may not be accepted or may be redirected to another service
Other important information for referring practitioners
- Suspect spinal cord compression, superior vena cava syndrome (SVC), high calcium (>3.0mmol/L), febrile neutropenia need to be referred to the Emergency Department urgently
- Haematology Department accepts referrals of patients with clinically abnormal lymph nodes without a biopsy
- For clinically stable small – volume lymph nodes and in a well patient with normal blood work suggest:
- Clinical monitoring recommended
- Consider biopsy
- For isolated neck lymphadenopathy, fine needle aspiration is usually the first investigation to exclude head and neck squamous cell cancer. Excisional biopsy of isolated neck lymph nodes should only be undertaken once squamous cell cancer has been excluded.
Referral requirements
A referral may be rejected without the following information.
Send referral
Hotline: 1300 364 938
Fax: 1300 364 952
Electronic: eReferral system
Mail: Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
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healthpathways
Login to Brisbane North Health Pathways:
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