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Normal head and neck lymph nodes in the paediatric population.

J Alves Rosa1, J S Calle-Toro2, M Kidd3

  • 1University Hospitals Bristol NHS Foundation Trust, UK; North Bristol NHS Trust, UK.

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Summary

This study defines normal head and neck lymph node sizes in children. Larger, rounder lymph nodes can be normal findings in pediatric patients, varying by location and age.

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Area of Science:

  • Radiology
  • Pediatric Imaging
  • Head and Neck Anatomy

Background:

  • Accurate assessment of pediatric head and neck lymph nodes is crucial for differentiating normal findings from pathology.
  • Establishing normative data is essential for interpreting imaging studies in children.

Purpose of the Study:

  • To establish the normal range of head and neck lymph node distribution, size, and shape in a pediatric population.
  • To provide reference values for radiologists interpreting pediatric brain magnetic resonance imaging (MRI).

Main Methods:

  • Retrospective review of 200 pediatric brain MRI examinations (age 5 months to 16 years).
  • Exclusion of cases with potential causes of lymphadenopathy.
  • Assessment of eight head and neck regions for lymph node presence, measurement of short and long axes, and calculation of the short/long axis ratio.

Main Results:

  • Deep cervical, submandibular, and posterior cervical nodes were most commonly identified.
  • Mean long axis measurements were largest for submandibular (19.7 mm), deep cervical (18.1 mm), and posterior cervical (15.4 mm) nodes.
  • Pre-auricular, occipital, and submental nodes showed the most oval shapes (S/L ratio 0.64, 0.63, 0.6).
  • A stronger positive correlation between occipital and deep cervical lymph node size and age was observed.

Conclusions:

  • This study characterizes normal head and neck lymph node appearance in healthy children.
  • Findings suggest that larger and rounder lymph nodes can be normal variants in pediatric patients.
  • Age and anatomical location are important factors in interpreting lymph node morphology.