Abstract
BackgroundNo normal measurements or specific size criteria have been described for cervical lymph nodes in children.ObjectiveTo determine the normal measurements of cervical lymph nodes in children on CT.Materials and methodsWe included 142 children (ages 1–17 years) who underwent cervical CT examination after high-energy trauma. We evaluated axial and coronal 2-mm reconstructions for lymph nodes at six cervical levels. For the largest lymph node at each level, we measured diameters in both the long and short axial axes and the long coronal axis.ResultsA total of 733 lymph nodes were measured in 142 children (62% boys, 38% girls). The greatest measured diameters were 14 mm for the short axis in the axial plane, 24 mm for the long axis in the axial plane and 28 mm for the long axis in the coronal plane. The Pearson correlation coefficient for age and lymph node size at Levels IV–VI was in the range of 0.19–0.47.ConclusionLymph nodes with an axial short-axis diameter exceeding 15 mm for Level II and 10 mm for all other cervical levels are uncommon in otherwise healthy children.
Highlights
One of the possible symptoms of infectious or malignant disease in children is lymphadenopathy
A total of 733 lymph nodes were measured in 142 children (62% boys, 38% girls)
The Pearson correlation coefficient for age and lymph node size at Levels IV–VI was in the range of 0.19–0.47
Summary
One of the possible symptoms of infectious or malignant disease in children is lymphadenopathy. For correct diagnosis of enlarged cervical lymph nodes on ultrasound, CT or MRI, it is important that normal short- and long-axis diameters of lymph nodes are known for all cervical levels and for all ages. Princess Máxima Centre for Paediatric Oncology, Utrecht, The Netherlands specific size criteria have been described for cervical lymphadenopathy in children and generally, the normal measurements as described for adults are applied for children as well. Lymph nodes with a short axis greater than 10 mm (mm) are usually considered abnormal; exceptions are deep cervical lymph nodes, in which a maximum diameter of 15 mm is considered within normal limits [1, 2, 4,5,6,7]. No normal measurements or specific size criteria have been described for cervical lymph nodes in children
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