English

Abstract

BACKGROUND Cervical lymphadenopathy is a common and usually benign finding especially in the paediatric age group. A thorough history and physical examination are necessary to establish a clinical diagnosis. This study was conducted to provide a clinical and pathological profile of cervical lymphadenopathy in the paediatric population visiting the tertiary care hospital in the Kumaun region of Uttarakhand. METHODS Particulars of the patients, relevant clinical history, routine blood investigation and radiological and histopathological findings were recorded in the clinical proforma after taking proper informed consent. Patients were initially given antibiotics for 1 week and observed for signs of clinical improvement of suspected infectious adenopathy. On follow-up, if there were no signs of improvement, the differential diagnosis was considered and FNAC of the cervical lymph nodes was performed. Data was analysed for clinical information such as age, sex, presenting symptoms and signs and FNAC findings. RESULTS In our study of 320 patients, 164 were males and 156 were females. Majority of the patients belonged to the age group of 11-15 years in both male (n=137; 83.5%) and female (n=140; 89.7%) patients. Most commonly involved subgroup of cervical lymph nodes was posterior group (n=267; 83.4%) followed by submandibular group (n=258; 80.6%). Most common symptom observed in the study was fever (n=242; 75.6%) followed by cough (n=194; 60.6%). Most common sign observed in the study was lymph node mobility (n=315; 98.4%) followed by tenderness (n=291; 90.9%). On follow-up, 45 patients (n=14.1%) responded to 1 week antibiotics course and showed signs of resolution. Remaining 275 patients (85.6%), were taken up for FNAC of the cervical lymph nodes. Most common FNAC finding was reactive adenitis (n=221; 80.3%). Other findings included tubercular lymphadenitis (n=21; 7.6%) and Hodgkin lymphoma (n=2; 0.7%). Out of 275 FNAC done, 31 reports (11.2%) were inconclusive. CONCLUSIONS Cervical lymphadenopathy is quite common in childhood. Majority cases are usually infective in origin and usually self-limiting. Children with cervical lymphadenopathy not showing any improvement on initial antibiotic therapy should be evaluated for other causes. KEY WORDS Cervical, Lymphadenopathy, Paediatric, Lymph Node.