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Childhood Head and Neck Lymphadenopathy: A Report by a Single Institution (2003-2017)

Paolo Indolfi1, Silverio Perrotta, Francesca Rossi

  • 1Unit of Hematology-Oncology, Pediatric Department of University "L. Vanvitelli", Naples, Italy.

Journal of Pediatric Hematology/Oncology
|August 11, 2018
PubMed

Insights

Acute infections are the most common cause of pediatric head and neck lymphadenopathy. Supraclavicular lymph node swelling warrants high suspicion for malignancy in children.

Area of Science:

  • Pediatric Hematology-Oncology
  • Pediatric Infectious Diseases
  • Pediatric Otolaryngology

Background:

  • Diagnostic and management algorithms for pediatric head and neck lymphadenopathy lack consensus.
  • Head and neck lymphadenopathy is a common presentation in children, requiring careful evaluation.

Purpose of the Study:

  • To analyze the causes of head and neck lymphadenopathy in children.
  • To establish a systematic diagnostic approach for pediatric head and neck lymphadenopathy.

Main Methods:

  • Retrospective analysis of 392 pediatric cases (under 18) with head and neck lymphadenopathy.
  • Data collected over a 15-year period (January 2003-December 2017) at a single institution.
  • Categorization of causes into infection, neoplasia, and reactive inflammatory changes.

Main Results:

  • Acute infections were the most frequent cause (56.1%) of head and neck lymphadenopathy in children.
  • Neoplasia accounted for 16.8% of cases, and nonspecific reactive changes for 24.9%.
  • Supraclavicular lymphadenopathy showed a high suspicion index for malignancy.

Conclusions:

  • Acute infections are the primary driver of head and neck lymphadenopathy in pediatric patients.
  • A significant proportion of cases are attributed to nonspecific reactive inflammation.
  • Malignancy should be strongly suspected in pediatric cases with supraclavicular lymphadenopathy.

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