Sevgi Buyukbese Sarsu, Kamil Sahin.
A retrospective evaluation of lymphadenopathy in children in a single center`s experience.
J Pak Med Assoc Jan ;66(6):654-7.

Objective: To determine the causes of lymphadenopathies in children living in our region, and detect the frequency of malignant disease. Methods: Our study evaluated demographic characteristics, lymph node involvement sites, tests, and viral serologiesperformed to search for the presence of infection, and ultrasonographic, and histologic findings of 1700 children who were referred to the outpatient clinics of the Paediatric Diseases and Paediatric Surgery between January 2012, and January 2015. Results: Our study population consisted of 1003 (59 %) boys, and 697 (41 %) girls aged less than 18 years.Definitive diagnosis of43 (8.68 %) patients with unilateral, and 452 (91.9 %) cases with bilateral lymphadenopathies was established. These cases had benign (n=455) , and malignant (n=40) etiologies. Two hundred and four (12 %) of them underwent biopsies. On histological evaluation TB (n=6), Kawasakisyndrome (n=3), catscratch syndrome (n=4), toxoplasmosis (n=17), sarcoidosis (n=22), non-Hodgkinlymphoma (n=23),Hodgkin lymphoma (n=15), and Langerhans cell histiocytosis (n=2) were detected. Histological examination of the biopsy specimens of 110 cases revealed nonspecific histological changes. A total of 1205 (70.88%) patients without definitive diagnosis had undergone ultrasonographic assessments, and clinical evaluations performed before or within 4 weeks after antibiotic therapy and revealed regression of the lesions. Conclusion: The most widely encountered cause of lymphadenopathy is infection. Most of them are secondary to nonspecific viral, and bacterial infections. Most frequently diagnosed viral infections are caused by cytomegalovirus (CMV), and Ebstein-Barr virus (EBV). The most important issue in patients presenting with complaints of lymphadenopathy is the detection of the underlying malignant disease (if any), with the most frequent being non-Hodgkin lymphoma. Excisional biopsy is still the gold standard diagnostic method. Although our hospital was not an oncology center, our malignancy rate was higher than seen in some series. This might be possibly due to referral of monitored patients to our regional hospital for biopsy.

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