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Fine needle aspiration in the evaluation of children with lymphadenopathy
1Department of Pediatrics, University of Louisville, Ky.
Objective:
To evaluate fine needle aspiration of enlarged lymph nodes in children.
Design:
Retrospective study of children who were referred for fine needle aspiration of a palpable lymph node that was of concern to their clinicians.
Setting:
Large, urban, tertiary care pediatric hospital.
Subjects:
One hundred nineteen patients (123 cases) aged 10 months through 21 years during the 30-month period from January 1990 to June 1992.
Results:
Aspirated material in 13 cases (10.6%) was deemed inadequate for cytologic diagnosis. In the remaining 110 cases, five aspirates revealed malignancy: two patients had Hodgkin's disease, one had non-Hodgkin's lymphoma, one had a leukemic infiltrate, and one had rhabdomyosarcoma. The findings in two cases were suspicious for malignancy, but the lymph nodes were found to be benign on excisional biopsy. No false-negative findings for malignancy were detected. The conditions of patients in the remaining 103 cases were diagnosed as a benign process, most commonly reactive lymphadenitis. Of 57 aspirates cultured, eight (14%) were positive for a microorganism. No significant complications were encountered in any of the 123 cases.
Conclusion:
Fine needle aspiration of enlarged lymph nodes in children is a safe, reliable (accuracy, 98%) procedure that often obviates the need for an excisional biopsy.