Etiology of Childhood Lymphadenopathy: A Report by a Single-center (2016-2018)

Abstract

Background: Lymphadenopathy is an enlargement of a lymph node. Pathologic Lymphadenopathy is when there is a symptom of infectious and noninfectious abnormalities or malignant diseases. Most Lymphadenopathies are benign and are associated with a short period of symptoms. Concerning diagnosis and management of adenopathy, especially in the case of children, research is still underway. For this reason, our study investigated and analyzed the causes of lymphadenopathy in children. Materials and Methods: This is a retrospective study conducted at the Pediatric Department of children's medical center of Tehran University of medical science. In this study, 130 children with cervical lymphadenopathy aged under 12 years underwent lymph node biopsy. Then under general anesthesia and evaluation of a senior pathologist, the lymph node was excised and biopsied. Results: During the study, twenty-five cases were excluded. Fifty-three patients (50.47%) demonstrated infection history, 22 cases (21%) had neoplasia, and reactive inflammatory changes with nonspecific origin were seen in 42 cases (40.0%). We observed chronic lymphadenitis in 3(2.9%) cases, and finally, 1(1.0%) case was metastatic. Mean lymph node size proved to be greater than two cm in metastatic (2.22cm), lymphoma (2.33cm), and granulomatous (3.17cm) lymphadenopathies. The average lymph node size turned out to be 1.53 cm in reactive lymph nodes (P =0.021). The diagnosis was obtained by excisional biopsy and histopathology. Conclusion: Acute infections are the most common reason for lymphadenopathy in pediatric conditions. It is better to be suspicious of malignancy with a high index in cases of cervical lymphadenopathy, especially if the lymph node size is higher than 2 cm. History, clinical features, and paraclinical tests can be used for lymphadenopathy in children.