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Long-Term Catheterization of the Intestinal Lymph Trunk and Collection of Lymph in Neonatal Pigs
Published on: March 5, 2016
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Management of Pediatric Persistent Asymptomatic Cervical Lymphadenopathy
Jacqueline E Harris1, Neil N Patel1, Katherine Wai1
1Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco Benioff Children's Hospital, San Francisco, California, USA.
Summary
Most pediatric persistent asymptomatic cervical lymphadenopathy (PACL) is benign. Ultrasound monitoring can safely manage PACL, avoiding unnecessary excisional biopsies and their associated risks in children.
Area of Science:
- Pediatric Otolaryngology
- Diagnostic Imaging
- Pediatric Surgery
Background:
- Persistent asymptomatic cervical lymphadenopathy (PACL) is a frequent diagnosis in pediatric otolaryngology referrals.
- Excisional biopsy under general anesthesia is the traditional diagnostic standard but carries inherent risks.
- Limited guidance exists for less invasive monitoring strategies for PACL in children.
Purpose of the Study:
- To evaluate the safety and efficacy of ultrasound monitoring for pediatric PACL.
- To determine if the majority of children with PACL can avoid excisional biopsy through non-invasive methods.
Main Methods:
- Retrospective review of patients under 18 with PACL undergoing neck ultrasound (2007-2021).
- Exclusion of patients with acute infections, congenital masses, or known systemic conditions.
- Multivariate logistic regression to identify factors influencing surgical intervention decisions.
Main Results:
- 15.2% of 197 patients underwent surgical biopsy; 90% of these revealed benign pathology.
- 26% of patients had repeat ultrasounds, showing a mean nodal size decrease.
- Pain, firmness, and absence of a fatty hilum on ultrasound correlated with surgical management.
Conclusions:
- The majority of pediatric PACL cases are benign and do not necessitate excisional biopsy for lymphoma exclusion.
- Serial clinical follow-up combined with neck ultrasound provides a safe monitoring approach for pediatric PACL.
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