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2020, Number 5

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Acta Pediatr Mex 2020; 41 (5)

Nodular lymphoid hyperplasia of the colon: a normal finding or an underestimated pathological condition?

Cadena-León JF, Sempértegui-Cárdenas PX, Ignorosa-Arellano KR, Toro-Monjaráz EM, Zárate-Mondragón FE, Cervantes-Bustamante R, Ramírez-Mayans JA

Language: Spanish
References: 55
Page: 215-221
PDF size: 216.68 Kb.


ABSTRACT

Nodular lymphoid hyperplasia (NLH) is defined as a cluster of ›10 extruding lymphoid nodules, for a long time this finding was considered normal in children, however it has been a commonly reported finding in patients with chronic abdominal pain, refractory constipation, unexplained anemia, digestive bleeding, chronic diarrhea and growth retardation. There is increasing evidence that associates with pathologies such as Helicobacter pylori infection, giardiasis, oxyuriasis, infectious colitis by amoeba or E.
coli; immunodeficiencies such as: common variable immunodeficiency, IgA deficiency, hypogammaglobulinemia, HIV; food allergy; inflammatory bowel disease and irritable bowel syndrome among others. NLH is diagnosed when the following histological criteria are observed: hyperplasic lymphoid follicles, mitotically active germinal centers with well-defined lymphocytes mantles, and lymphoid follicles localized in the mucosa or submucosa. The treatment is aimed at the underlying cause although this is not always possible to establish, so studies have been conducted with the use of empirical treatments based on elimination diets and salicylates. There is evidence of the risk of malignant transformation, which is why some authors consider carrying out serial studies although the duration and intervals between them have not been well defined. It is important that the health professional knows the guiding endoscopic findings of lymphoid nodular hyperplasia, their most related gastrointestinal symptoms, the etiologies in which can occur, and the recognized potential of malignization to provide a better diagnosis and, thereof, the treatment in the paediatric patient. The objective of this article is to provide current information regarding its definition, epidemiology, etiology, clinical manifestations, diagnosis and treatment.


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