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[Diagnostic evaluation of cervical adenopathies in childhood]
M J Redondo Granado1, F J Alvarez Guisasola, I Gómez Martín
1Departamento de Pediatría, Hospital Clínico Universitario de Valladolid.
Insights
Cervical lymphadenopathy in children is often benign, but 16% of cases studied had neoplastic conditions like thyroid cancer or lymphoma. Malignant tumors showed longer evolution times and lower LDH levels compared to benign causes.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Pathology
Context:
- Cervical lymphadenopathy is a common clinical sign in children.
- Distinguishing between benign and malignant causes is crucial for appropriate management.
Purpose:
- To analyze the causes of cervical lymphadenopathy in hospitalized children.
- To identify clinical and laboratory differences between benign and malignant conditions.
Summary:
- A study of 45 children with cervical lymphadenopathy found 16% had neoplastic conditions (thyroid cancer, Hodgkin's lymphoma, non-Hodgkin's lymphoma).
- Benign causes included infectious mononucleosis, non-specific adenitis, and mycobacterial infections.
- No significant differences were observed in age or lymph node morphology.
- Malignant tumors had a longer evolution time (16.4 weeks vs. 9.6 weeks) and lower mean LDH levels (214 U/L vs. 614 U/L) compared to benign conditions.
- Supraclavicular lymph node location was exclusively associated with lymphoma.
Impact:
- Highlights the importance of considering neoplastic causes in pediatric cervical lymphadenopathy.
- Suggests LDH levels and evolution time may aid in differential diagnosis.
- Informs clinical decision-making for pediatric patients presenting with cervical lymphadenopathy.
Abstract:
Between 1985 and 1990, 45 children were studied in an inpatient basis hospital because of cervical lymphadenopathy. This was the most important clinical sign in these patients. Forty-three had true adenitis. In the others, one was submaxillitis and one a sarcoma. The age range was from 2.1 to 13.3 years. Seven children (16%) had neoplastic adenitis (2 papillary carcinoma of the thyroid, 4 Hodgkin's lymphoma and one non-Hodgkin's lymphoma). Thirty-six patients had benign disorders (18 mononucleosis infections, 7 nonspecific adenitis, 5 infections of mycobacteria, 2 of toxoplasma and 2 of rickettsia, one cervical Whipple and one desmopathic adenitis). We did no find any differences related to age or morphological characteristics of the lymph nodes. The evolution time in patients with malignant tumors was 16.4 weeks and 9.6 weeks in the benign group. All of the cases with supraclavicular location had a lymphoma. The mean LDH in patients with malignant tumors was 214 U/L and 614 U/L in those with non-malignant tumors (p < 0.01).
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