Sotelo-Cruz N, Cordero-Olivares A, López-Cervantes G, Romero-Esquer JA

Language: Spanish
References: 19
Page: 431-435
PDF size: 80.80 Kb.

ABSTRACT

Background: Physicians in daily practice frequently attend children who present an increase in lymph node size. Care should be undertaken to determine which children require biopsy. Our objective was to analyze the usefulness of the peripheral lymph node biopsy in pediatric diagnosis. Methods: We reviewed histological reports of 364 lymph node biopsies. Variables were age, sex, lymphadenopathy evolution time, laboratory and imaging studies, and histopathology diagnoses. Parametric and nonparametric tests were used. Results: There were 211 males (57.9 %) and 153 females (42.0 %), the 1- to 6-year age group included 50.8% of cases. Average disease-evolution time was 5 months, and the predominant anatomic site was the cervical region. Histological report was reactive lymphoid hyperplasia (RLH) in 46.9%, followed by neoplasms in (24%), and granulomas (14.5%). Other diagnoses and normal lymph nodes represented 14.6 %. Of the 95 patients with high-risk lymphadenopathy, 29 cases had oncological diagnoses. Spearman coefficient was R² = 0.3485. To obtain a specific diagnosis indicates the probability of disease in lymph nodes of risk areas. However, the majority of the diagnoses were obtained from lymph nodes in different areas (Fisher test, p ‹0.001). In 25 children with RLH, the binominal probability of diagnosis in the second biopsy was p = 0.0493. There was a ›75% chance for detecting disease. Conclusions: Peripheral lymph nodes within high-risk regions indicate probability relationship for determining disease. In persistent lymphadenopathy with an initial report of RLH, it is important to consider a second biopsy with high probability to obtain a specific diagnosis.

REFERENCES

1. Ghirardeli ML, Jemos V, Gobbi PC. Diagnostic approach to lymph node enlargement. Haematologica 1999; 84:242-247.

2. Kanwar VS, Sills RH. Lymphadenopathy follow-up (serial on internet). 2009 May, Section 1-5. Disponible en://emedicine.medscape.com/article/ 956340-overview

3. Sotelo-Cruz N, Cordero-Olivares A, López-Cervantes G, Camacho-Ramírez C. Estudio de la adenopatía en el niño. Rev Mex Puer Pediatr 1994;2:36-39.

4. Neville HL, Andrassy RJ, Lally KP, Corporon C, Ross MI. Lymphatic mapping with sentinel node biopsy in pediatric patients. J Pediatr Surg 2000; 35:961-964.

5. Nield LS, Kamat D. Lymphadenopathy in children. When and how to evaluate. Clin Pediatr 2004;43:25-33.

6. Ridder GJ, Techanau Ihling K, Boedeker CC. Ultrasound-guided cutting needle biopsy in the diagnosis of head and neck masses. Laryngoscope 2005;115:376-377.

7. Drut R, Drut M, Pollono D, Tomarchio S, Ibáñez O, Urritia A, et al. Fineneedle aspiration biopsy in pediatric oncology patients. J Ped Hematol Oncol 2005;27:370-376.

8. Quero-Hernández A, Villarreal-Chávez L, Coronado-García R, Tenorio- Rodríguez H, Álvarez-Solís R. Biopsia escisional de ganglios periféricos en el diagnóstico de neoplasias malignas en niños. Rev Mex Pediatr 2006;73:9-13.

9. Ramos-Salas JE. Probabilidad y Modelos de Distribución de Probabilidad en Estadística Platicada. México: Noriega Editores; 2005. pp. 35-70.

10. Statistical Software JMP version 5.0.5 (Academic). SAS Institute Inc, Cary, NC; 2004.

11. Pineda-Daboin KM, Rosas-García MI, Rosas-Uribe A. Biopsia de ganglio linfático: indicaciones, tipos, procesamiento e interpretación. Patol Rev Latinoam 2008;46:33-44.

12. Dórame-Castillo R, Cano-Rangel MA, Durazo-Arvizu MA. Infección por virus de la inmunodeficiencia humana: experiencia en el Hospital Infantil del Estado de Sonora. Bol Clin Hosp Infant Edo Son 2008;25:22-25.

13. Sklair-Levy M, Amir G, Spectre G, Levensart P, Applbaum Y, Agid R, et al. Image-guided cutting-edge-needle biopsy of peripheral lymph nodes and superficial masses for the diagnosis of lymphoma. J Comput Assist Tomogr 2005;29:369-372.

14. Sotelo-Cruz N, Cordero-Olivares A, López-Cervantes G, Aguirre-Villa FJ. Utilidad de la biopsia de ganglio linfático en el niño. Rev Mex Ped 1988;55:229-235.

15. 15.Yaris N, Cakir M, Sozen E, Cobanoglu V. Analysis of children with peripheral lymphadenopathy. Clin Pediatr 2006;45:544-549.

16. Knight PJ, Mulne AF, Vassy LE. When is lymph node biopsy indicated in children with enlarged peripheral nodes? Pediatrics 1982;69:391-396.

17. Soldes O, Younger JG, Hirchl RB. Predictors of malignancy peripheral lymphadenopathy. J Pediatr Surg 1999;34:1447-1452.

18. Scagni P, Peisino MG, Bianchi M, Morello M, Sardi N, Linari A, et al. Kikuchi-Fujimoto disease is a rare cause of lymphadenopathy and fever unknown origin in children: report of two cases and review of the literature. J Pediatr Hematol Oncol 2005;27:337-340.

19. Camacho-Badilla K, Cañas-Coto A, Soriano-Fallas A, Carranza- Portocarrero A, Ávila-Agüero M. Enfermedad de Kikuchi-Fujimoto en pediatría. Reporte de un caso y revisión de la literatura. Gac Med Mex 2005;141:53-56.