Lymphadenopathy in children: A streamlined approach for the surgeon - A report from the APSA Cancer Committee
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Published on: March 18, 2020
Christa N Grant1, Jennifer Aldrink2, Timothy B Lautz3
1Division of Pediatric Surgery, Penn State Children's Hospital, Department of Surgery, Milton S. Hershey Medical Center, Hershey, PA.
Insights
This guide helps surgeons manage pediatric lymphadenopathy, offering an algorithm for evaluation and treatment. It emphasizes timely diagnosis and surgical intervention for enlarged lymph nodes in children.
Area of Science:
- Pediatric Surgery
- Pediatric Oncology
Background:
- Lymphadenopathy is a frequent pediatric concern requiring surgical evaluation.
- Differentiating causes is crucial for timely diagnosis and minimizing intervention morbidity.
Purpose of the Study:
- Provide a management guide for pediatric lymphadenopathy.
- Outline the role and timing of surgical intervention in pediatric lymphadenopathy workup.
Main Methods:
- Literature search for "lymphadenopathy in children".
- Review of all manuscript types, prioritizing guidelines and algorithms.
- Development of a surgical management algorithm based on evidence.
Main Results:
- An algorithm for pediatric lymphadenopathy workup and treatment was developed.
- The algorithm emphasizes the role and timing of surgical intervention.
- Common etiologies and presentations of pediatric lymphadenopathy are summarized.
Conclusions:
- The review offers a straightforward algorithm for evaluating pediatric lymphadenopathy.
- Emphasis is placed on malignancy risk assessment and surgical management.
- This guide aids surgeons in providing reassurance and timely diagnosis.
Background/Purpose:
Lymphadenopathy is a common complaint in children. Pediatric surgeons are often called upon to evaluate, treat, and/or biopsy enlarged lymph nodes. With many nonsurgical causes in the differential diagnosis, the surgeon plays the important role of providing reassurance and timely diagnosis while minimizing the pain and morbidity associated with surgical interventions in children. The purpose of this summary paper is to provide a management guide for surgeons working up children with lymphadenopathy.
Materials/Methods:
The English language literature was searched for "lymphadenopathy in children". All manuscript types were considered for review, regardless of medical specialty, with emphasis placed on published guidelines, algorithms, and reviews. After thorough review of these manuscripts and cross-referencing of their bibliographies, the attached algorithm was developed, with emphasis on the role and timing of surgical intervention.
Results:
The APSA Cancer Committee developed the attached algorithm to fill a gap in the surgical literature. It outlines lymphadenopathy workup and treatment with emphasis on the role and timing of surgical intervention.
Conclusion:
This review defines and summarizes the common etiologies and presentations of lymphadenopathy in children, and offers a straightforward algorithm for evaluation of and treatment with an emphasis on malignancy risk and surgical management.
Type Of Study:
Summary paper.
Level Of Evidence:
Level V.
