Abstract
Background: Peripheral lymphadenopathy manifests in a variety of benign and malignant conditions and is often challenging to distinguish pathologic from non-pathologic etiology based on clinical presentation alone. Therefore, lymph node biopsy is often required as an essential part of management. This study aimed to determine the causes of peripheral lymphadenopathy in children needing excision biopsy in our setting and establish a correlation with clinical features and laboratory findings. Methods: A retrospective review of medical records of children aged 0-14 years undergoing lymph node biopsy at our institution, between January 2015 and June 2018, was conducted. Demographic, microbiological, and histopathological findings were reviewed. Results: A total of 69 patients underwent lymph node biopsy, the majority of whom were male (n=40, 58%), with a mean age of 7.9 years. The histopathological findings confirmed lymphoma (n=27), tuberculosis (n=24), benign reactive changes (n=14), and Langerhan Cell Histiocytosis (n=4). Cervical lymph nodes were most frequently involved (n=64). Associated symptoms included fever (n= 27), weight loss (n=2) and cough (n=7). Only one patient developed a postoperative complication (wound infection). A clinical diagnosis of tuberculosis (TB) had been presumed in 19 patients, but only 2 (11%) were confirmed to have TB, whereas10 were found to have histopathological findings of lymphoma. Conclusion: Excisional biopsy is useful in the management of children with lymphadenopathy, allowing treatment to be initiated based on a histopathological diagnosis.
Highlights
Lymphadenopathy is common in the pediatric age group; as many as 90% of children between ages 4-8 years manifesting enlarged lymph nodes at some point, the incidence of unexplained and significant lymphadenopathy is less than 1%.[1,2]
The biggest challenge faced by a physician is to distinguish pathologic from non-pathologic etiology and it is often difficult to ascertain the cause based on clinical presentation alone
A lymph node biopsy was performed when a significantly enlarged lymph node persisted or increased in size, did not respond to conservative treatment, and/or when there was a clinical suspicion of tuberculosis (TB) or lymphoma
Summary
Lymphadenopathy is common in the pediatric age group; as many as 90% of children between ages 4-8 years manifesting enlarged lymph nodes at some point, the incidence of unexplained and significant lymphadenopathy is less than 1%.[1,2] Based on the duration of symptoms, lymphadenopathy can be termed as either acute (6 weeks). The biggest challenge faced by a physician is to distinguish pathologic from non-pathologic etiology and it is often difficult to ascertain the cause based on clinical presentation alone. It is this group of children that may benefit from a lymph node biopsy to reach a definitive diagnosis.[1,2] Tissue sampling is frequently required for diagnosis. Peripheral lymphadenopathy manifests in a variety of benign and malignant conditions and is often challenging to distinguish pathologic from non-pathologic etiology based on clinical presentation alone. This study aimed to determine the causes of peripheral lymphadenopathy in children needing excision biopsy in our setting and establish a correlation with clinical features and laboratory findings
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