Evaluation of children with lymphadenopathy followed by the Inönü University Turgut Özal Medical Center for malignant potential

Aim: Whether the lymph node enlargement is pathologic or not, it is related to the age of the patient and the size and localization of enlarged lymph node. However, in general, the lymph node is greater than 10 mm are defined as lymphadenopathy. The aim of this study is to evaluate the epidemiological characteristics, history, clinical and laboratory findings of the patients followed at our hospital between 1 January 2009 and 1 November 2012 for the potential effects of malignancy and to determine the factors which increase the risk of malignancy. Patients and Methods: The 530 patients between the age of 3 months-18 years who have lymphadenopathy greater than 10 mm in diameter included in this study. It was necessary for the patients to be followed up at least 3 months. The files of these patients were searched retrospectively. The efficacy of clinical history, phisicial examination and laboratory findings were studied about the distinguishment benign from malign lymphadenopathies. Results: Totally 530 patients with lymphadenopathy were included in the study and 347 of them were male, 183 were female. Most of the patients were at the range of 6-11 ages. The malignancy was detected in 31 of the (5,8%). The patients older than 12 years who present with night sweat, weight loss, generalized lymphadenopathy especially lymph node greater than 2 cm in diameter and the localization of posterior cervical, supraclavicular, mediastinal and abdominal in laboratory findings of anemia, trombositopenia, leucopenia, elevation of CRP, ESR, LDH levels have increasing risk of malignancy. It is detected that the patients who present more than one of the clinical history, physical examination and laboratory findings have increasing risk of malignancy up to 60%. Conclusion: the important signs should be evaluated as clues at the patients who applied to hospital with lymphadenopathy. Further clinical investigations of these patients should be done immediately. Especially, the diagnostic biopsy should be done without loss of time to eleminate malignancy for the patients with increased risk of malignancy who have diagnosed more than one history, physical exam and laboratory findings. Unnecessary diagnostic procedures should be avoided at the patients with the range of age 0-5 years who have neck lymphadenopathy smaller than 2 cm in diameter and response to treatment, benign clinical picture at USG, and these patients can be followed up undergoing biopsy at an early period of observation.