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Granulomatous lymphadenitis in children.

D R Benjamin

    Archives of Pathology & Laboratory Medicine
    |August 1, 1987
    PubMed
    Summary

    Granulomatous inflammation in children

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    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.

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