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Pediatric Lymphoid and Histiocytic Lesions in the Head and Neck
A Auerbach1, J J Schmieg2, N S Aguilera3
1The Joint Pathology Center, Silver Spring, MD, USA. aaron.auerbach.civ@mail.mil.
Insights
Pediatric head and neck lesions involving lymphoid and histiocytic cells are often benign, but accurate diagnosis of neoplastic cases is crucial for effective treatment. This review focuses on diagnostic criteria for both benign and malignant conditions in children.
Area of Science:
- Pediatric Pathology
- Head and Neck Oncology
- Diagnostic Criteria
Background:
- Most head and neck lesions in children are benign lymphoid or histiocytic in origin.
- Palpable lymph nodes are common in children aged 4-8, with many resolving spontaneously.
- Accurate diagnosis is vital for appropriate management of both benign and neoplastic conditions.
Purpose of the Study:
- To review benign and malignant lymphoid and histiocytic lesions of the head and neck in pediatric patients.
- To focus on diagnostic criteria for these pediatric head and neck lesions.
- To discuss common and emerging entities in pediatric lymphohistiocytic pathology.
Main Methods:
- Review of literature on pediatric head and neck lymphoid and histiocytic lesions.
- Focus on diagnostic criteria for differentiating benign from malignant conditions.
- Discussion of common lymphomas and histiocytic disorders in children.
Main Results:
- Non-malignant lymphoid proliferations, infections, and reactive conditions are common.
- Classic Hodgkin lymphoma and Burkitt lymphoma are frequently seen in pediatric head and neck.
- Pediatric-type follicular lymphoma and challenging histiocytic lesions are also discussed.
Conclusions:
- Accurate diagnosis of pediatric head and neck lymphoid and histiocytic lesions is essential for treatment.
- Understanding diagnostic criteria aids in differentiating benign reactive processes from malignancies.
- This review provides a comprehensive overview for clinicians and pathologists.
Abstract:
Lymphoid and histiocytic lesions of the head and neck in pediatric patients is a fascinating topic as most of these lesions are benign, but that the neoplastic cases are essential to diagnose accurately for appropriate treatment. It is thought that 90% of children will have palpable lymph nodes between the ages of 4 to 8; most, but not all, are non-malignant and some resolve spontaneously without treatment. This paper will look at many of the benign and malignant lesions of both lymphocytic and histiocytic origin that present in the head and neck of children focusing on their diagnostic criteria. There is a very pertinent discussion of nonmalignant lymphoid proliferations, as infections and other reactive conditions dominate the pathology of pediatric lymphohistiocytic head and neck lesions. Discussion of those lymphomas which arise more frequently in the head and neck focuses on those seen in children and young adults such as classic Hodgkin lymphoma and Burkitt lymphoma, as well as new more controversial entities such as pediatric-type follicular lymphoma. Histiocytic lesions, both benign and malignant, are described and may be challenging to diagnose.
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