Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society·2000
Area of Science:
Pediatric Pathology
Infectious Diseases
Microbiology
Background:
Granulomatous inflammation in pediatric peripheral lymph nodes is uncommon.
Atypical mycobacteria are a frequent cause, particularly in head and neck regions.
Purpose of the Study:
To systematically investigate the spectrum of granulomatous inflammation in pediatric peripheral lymph nodes.
To correlate histopathologic features with clinical, epidemiologic, and microbiologic data.
To assess long-term outcomes.
Main Methods:
Systematic review of 85 pediatric peripheral lymph node cases over 10 years.
Histopathologic examination of lymph node specimens.
Correlation with clinical, epidemiologic, and microbiologic data.
Main Results:
Atypical mycobacteria, predominantly Mycobacterium avium-intracellulare, caused most cases (60/85), especially in head/neck nodes of children aged 1-10 years.
The condition was more common in girls (1:3 ratio) and peaked between ages 2-5 years.
Other sites and older children rarely yielded a cause, with good outcomes post-excision.
Histopathology showed variable features, not reliably predicting cause or course.
Clinical and bacteriologic data were most useful for diagnosis.
Conclusions:
Atypical mycobacterial infection is the primary cause of granulomatous lymphadenitis in children, predominantly affecting the head and neck.
Clinical presentation and bacteriologic investigations are key diagnostic tools.
Surgical excision generally leads to favorable outcomes.