Related Experiment Video
Updated: Jun 28, 2025
Isolation of Human Lymphatic Endothelial Cells by Multi-parameter Fluorescence-activated Cell Sorting
Published on: May 1, 2015
Outcomes of Referrals in Pediatric Patients With Peripheral Lymphadenopathy
Kathryn A Six1, Inmaculada B Aban2, Gabriel M Daniels3
1Atrium Health Levine Children's Cancer & Blood Disorders, Wake Forest University School of Medicine, Charlotte, NC.
Insights
Pediatric lymphadenopathy size is a key indicator for potential malignancy. Larger lymph nodes (LN) significantly increase the odds of cancer, aiding in early diagnosis and appropriate subspecialty referrals.
Area of Science:
- Pediatric Oncology
- Diagnostic Imaging
- Clinical Medicine
Background:
- Lymphadenopathy is a frequent reason for pediatric subspecialty referrals, causing parental anxiety.
- Efficient healthcare utilization requires identifying children needing specialized evaluation for enlarged lymph nodes.
Purpose of the Study:
- To determine the association between maximum lymph node (LN) size and malignancy in pediatric patients.
- To evaluate LN size as a predictor for cancer diagnosis in children.
Main Methods:
- Retrospective study of pediatric patients referred for lymphadenopathy (2012-2021).
- Logistic regression analysis to assess the relationship between LN size and malignancy.
- Calculation of odds ratio, area under the curve, sensitivity, and specificity.
Main Results:
- A significant association was found between LN size and cancer diagnosis (P <0.0001).
- Each centimeter increase in maximal LN dimension correlated with a 2.3 times higher odds of malignancy (OR=2.3).
- LN size demonstrated good correlation with cancer diagnosis (AUC=0.84); a 2 cm cut-off yielded high sensitivity (1.0) but moderate specificity (0.54).
Conclusions:
- Maximum lymph node size is a significant predictor of malignancy in pediatric patients with lymphadenopathy.
- This finding can help streamline subspecialty referrals and reduce healthcare costs.
- Further research may refine LN size criteria for optimal diagnostic accuracy.
Abstract:
Lymphadenopathy is a common reason for referral to a subspecialist, which may result in significant anxiety for parents. Understanding which patients require a subspecialty referral for lymphadenopathy is key to streamlining health care utilization for this common clinical entity. This is an IRB-approved retrospective study examining pediatric patients consecutively referred to pediatric hematology oncology, otolaryngology, or surgery for lymphadenopathy from 2012 to 2021 at a free-standing tertiary-care children's hospital. Logistic regression was fitted to examine the association between the maximum size of the lymph nodes (LN) and a diagnosis of malignancy. The odds ratio, area under the receiver operator curve, sensitivity, and specificity were estimated. We found a significant association between LN size and cancer diagnosis. For every centimeter increase in the maximal dimension of LN, there was an estimated 2.3 times increase in the odds of malignancy (OR=2.3, 95% CI: 1.65-3.11; P <0.0001). The estimated area under the curve (0.84, 95% CI: 0.78-0.90) indicated that LN size correlated well with cancer diagnosis. A LN cut-off size of 2 cm resulted in an estimated sensitivity of 1.0 (95% CI: 0.87-1.00) and specificity of 0.54 (95% CI: 0.46-0.61). Maximum LN size may be a predictor of malignancy among pediatric patients with lymphadenopathy.
