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Clinico-pathological profile of pediatric lymphadenopathy
M Pradeep Reddy1, Nekhil Moorchung, Arun Chaudhary
1Command Hospital, Udhampur (J&K) and Military Hospital, Mathura, Uttar Pradesh, India. mettupradeepreddy@hotmail.com
Insights
Pediatric peripheral lymphadenopathy is most commonly caused by treatable tuberculosis. Fine-needle aspiration cytology (FNAC) is a highly sensitive and specific diagnostic tool for pediatric lymph node evaluation.
Area of Science:
- Pediatric Medicine
- Pathology
- Infectious Diseases
Background:
- Peripheral lymphadenopathy is a common presentation in pediatric patients.
- Accurate etiological diagnosis is crucial for effective management.
Purpose of the Study:
- To investigate the clinico-pathological characteristics of pediatric peripheral lymphadenopathy.
- To determine the causes of significant pediatric lymphadenopathy.
Main Methods:
- Prospective study of 100 children (1 month to 12 years) at a tertiary care hospital.
- Inclusion of detailed hematological, microbiological, radiological, and serological investigations.
- Comparison of Fine-Needle Aspiration Cytology (FNAC) with lymph node biopsy.
Main Results:
- Tubercular lymphadenitis was the most frequent diagnosis (35%).
- Chronic tonsillopharyngitis accounted for 15% of cases.
- Etiology remained undetermined in 44% of cases despite comprehensive testing. FNAC showed 94% sensitivity and 100% specificity.
Conclusions:
- Tubercular lymphadenitis is the primary treatable cause of pediatric peripheral lymphadenopathy.
- A significant proportion of pediatric lymphadenopathy cases remain undiagnosed.
- FNAC is a reliable diagnostic method, comparable to biopsy, when performed and interpreted by experts.
Objective:
To study the clinico-pathological profile of significant pediatric peripheral lymphadenopathy and to arrrive at an etiological diagnosis.
Methods:
Prospective study in a tertiary care hospital setting. One hundred consecutive children reporting to pediatric OPD from 1 January 1995 to 31 December 1998, aged 1 month to 12 years were studied.
Results:
The commonest aetiology diagnosed was tubercular lymphadenitis in 35% cases, followed by chronic tonsillopharyngitis in 15% cases. Lymphomas, AIDS and infectious mononucleosis constituted 3, 2 and 1 cases each. Aetiology could not be ascertained in 44 (44%) children even after detailed haematological, microbiological, radiological and serological investigations. FNAC's sensitivity and specificity as compared to 'gold standard of excision lymph node biopsy was 94% and 100% respectively.
Conclusion:
Tubercular lymphadenitis was the commonest treatable entity of significant pediatric peripheral lymphadenopathy. A majority of the cases even after thorough evaluation, remained undiagnosed. FNAC as a diagnostic modality is almost as sensitive and as specific as excision lymph node biopsy when an adequate aspirate is examined by expert eyes.