2008, Number 1
Clinicopathologic profile of cervical lymphadenopathy in children Eight years experience in a Regional General Hospital
Amador-Sánchez R, Campos-Lozada I, Fernández-Ramos M, Magaña-Mahler JA, Zarco-Contreras J
Full text
Language: Spanish
References: 6
Page: 10-14
PDF size: 395.49 Kb.
ABSTRACT
Introduction: Cervical lymphadenopathy in children is the clinical expression of a variety of diseases is sometimes difficult to differentiate and can be confused with other neck injuries less common. If the disturbance node over an inch is not resolved in the course of 6-8 weeks of conservative management must follow tomársele excisional biopsy to determine etiology of the lesion. It is for the Pediatric Surgeon obtain biopsy or lymph nodes from the neck representative histopathology in the diagnosis and give the child full treatment course.Material and Methods: We conducted a retrospective review, observational and descriptive cross a series of cases of cervical lymph node biopsy in the neck representative of children referred to pediatric surgery service for family practitioners, pediatricians and pediatric hematologists in our area of influence the period June 1998 to February 2006 to analyze measures of central tendency with age, sex, cervical topography, type of injury and monitoring of children based on the final pathological report.
Results: We obtained biopsies of lymph nodes involved to provide the best material to the pathologist in the fresh impressions and review and final determination for the diagnosis, but suspects the diagnosis of malignancy was confirmed by immunohistochemical study of 61 patients obtained so of them were 42 males and 19 women.
The age range was from eight months to 15 years with a median of seven years and an average of 7.72 years. By age groups had two infant children, 21 preschool children, 19 schools and 19 adolescents. Lymphadenopathy showed a topography in anterior midline in four children in a child later, nine submaxillary, a supraclavicular, three bilateral, 22 right and 21 left.
The histopathological results we had 37 with reactive follicular hyperplasia, five with Hodgkin’s disease, four with non-Hodgkin lymphoma, two of Castleman’s disease, one of Disease Rosai Dorfman a Angioino-munoblástica lymphadenopathy, a histiocytoid Hemangioendothelioma, a benign schwannoma, a salivary gland pleomorphic adenoma, a remnant of thymic cysts in thymic neck , five granulomatous lymphadenitis and two Cryptococcus lymphadenitis.
The 37 patients were monitored reactive follicular hyperplasia in the medical unit of assignment, it was considered cured at the seven patients who received medical management for cryptococcosis and granulomatous lymphadenitis, which responded satisfactorily disappeared neck injuries, as well as those who were resected thymic remnants in the neck and salivary gland pleomorphic adenoma and finally the remaining 15 patients with malignant and invasive biological behavior are handled in pediatric hematology unit so far.
Discussion: More than half of the biopsied patients had nonspecific reactive follicular hyperplasia remain consistent with those reported in the literature. Immunohistochemical techniques allowed to diagnostic accuracy in suspected cases of malignancy, therefore it is necessary to have a high index of suspicion.
REFERENCES