DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20210655

Evaluation of paediatric lymphadenopathy at a rural tertiary care centre

Mamatha Pakala, Shreya Tanneru, Prasada Thanda, Prabhakar Vuppala

Abstract


Background: The aim and objectives of the present study was to determine the various etiologies of lymphadenopathy in children in our region and its associated clinical findings and prevalence of malignancy in children presented with significant lymphadenopathy.

Methods: Sixty-five patients with significant lymphadenopathy charts were reviewed retrospectively from department of Paediatrics and Paediatric Surgery during the period of September 2018-2020. Patient’s records were evaluated in terms of age, gender, complaints, and characteristics of lymph nodes in terms of site, consistency, discharge, sinus and clinical course of a patient. Physical findings of all the cases were noted. Hematological and serological tests were done to know the source of infection. Clinical findings and laboratory results were corroborated with pathological diagnostic tests like FNAC and Excision biopsies in children with significant lymphadenopathy

Results: The etiology was confirmed in 94% children and couldn’t be diagnosed in 6% children presented with significant lymphadenopathy. On evaluation commonest etiology was infection with reactive hyperplasia in 58% of children secondary to bacterial or viral infections, Kawasaki disease, suppurative lymphadenitis in 17%, tuberculous lymphadenitis in 14%, and malignancy in 11%. Majority of children presented with cervical lymphadenopathy. An unusual presentation of Non Hodgkin lymphoma as intestinal obstruction with no significant mass per abdomen, a case of nasopharyngeal carcinoma presented as torticollis due to massive unilateral cervical lymphadenopathy were diagnosed

Conclusions: The most widely encountered cause of lymphadenopathy in children was infection. Most of them are secondary to non specific viral or bacterial infections. The most important concern in children presenting with complaints of lymphadenopathy is the detection of underlying malignant disease. There was significant malignancy rate in our study in children with lymphadenopathy with few atypical presentations. Excisional biopsy is the gold standard method to confirm the diagnosis.


Keywords


Lymphadenopathy, Malignancy, Pediatric

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