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Pediatric Cervical Lymphadenopathy

Michael S Weinstock1,2, Neha A Patel1, Lee P Smith1

  • 1Cohen Children's Medical Center, Hofstra Northwell School of Medicine, New Hyde Park, NY.

Pediatrics in Review
|September 2, 2018
PubMed

Insights

Pediatric cervical lymphadenopathy is common, often viral. This review guides clinicians on evaluating swollen neck lymph nodes in children, covering history, exams, tests, imaging, and biopsy to differentiate causes like infections and rare malignancies.

Area of Science:

  • Pediatric Medicine
  • Diagnostic Imaging
  • Oncology

Background:

  • Cervical lymphadenopathy is highly prevalent in children aged 4-8 years, necessitating a structured diagnostic approach.
  • The differential diagnosis includes common viral and bacterial infections, as well as rare but critical malignancies.

Purpose of the Study:

  • To provide pediatric clinicians with a framework for evaluating pediatric cervical lymphadenopathy.
  • To guide history taking, physical examination, laboratory testing, imaging, and biopsy decisions.
  • To clarify the roles and limitations of ultrasonography, CT, and MRI in pediatric lymphadenopathy evaluation.

Main Methods:

  • Systematic review of diagnostic approaches for pediatric cervical lymphadenopathy.
  • Analysis of common etiologies including viral, bacterial, and malignant causes.
  • Evaluation of current imaging modalities: ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI).

Main Results:

  • Viral infections are the most frequent cause of cervical lymphadenopathy in children.
  • Bacterial infections represent the second most common etiology.
  • Malignancies, though rare, are the most serious concern requiring timely diagnosis.

Conclusions:

  • A systematic evaluation is crucial for pediatric cervical lymphadenopathy.
  • Ultrasonography plays a significant role, but CT and MRI have specific utilities.
  • Accurate diagnosis relies on integrating clinical findings with appropriate investigations.

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