Peripheral lymphadenopathies of childhood

SUMMARY PERIPHERAL LYMPHADENOPATHİES OF CHİLDHOOD Abdullah Kumral, MD. OBJECTIVES : Peripheral lymphadenopathies are a frequently encountered problem in clinical practice. Since they can sometimes be the only sign of underlying disease the physician must be knowledgable in his / her approach to be patient. The aim of this study was to formulate a diagnostic algorythm, which is easily applicable and free of unnecassry tests, for the evaluation of the pediatric patient presenting with peripheral lymphadenopathies. PATİENTS AND METHODS : All patients who had applied to Dokuz Eylül University Department of Pediatric Hematology - Oncology between January 1988 and December 1998 because of lymphadenopathy were included in the study. The value effectivity of the history, physical examination, attributes of the lymphadenopathy and laboratory findings in diagnosing lymphadenopathies as either benign or malignant were evaluated. Properties of the lymphadenopathies and the financial costs of diagnosis and treatment of patients diagnosed with benign or malignant lymphadenopathies were researched evaluated. RESULTS : 200 patients were included in the study, of which 55 were female and 145 were male. The average age of all subjects was 7,67 ± 4,59 (1-17) years. Lymphadenopathies were first noticed by the patients between 2 and 730 days (mean 25 days) before their initial visit to our clinic. 140 patients were diagnosed as having benign lymphadenopathies whereas 60 cases of malignant lymphadenopathies were reported. Anemia (r=0.16, p<0.004), platelet count (r=0.17, p<0.002), size of enlarged lymphnodes (r=0.23, p<0.0002) and the presence of supraclavicular lymphadenopathy (r=0.22, p<0.0004) were found to be of significance in the differential diagnosis of benignfrom malignant lymphadenopathies. Total expenses of diagnosis and treatment were higher in patients recieving diagnosis of malignant nodes (p<0.05). CONCLUSIONS : A detailed physical examination and simple laboratory testing are essential and sufficient for distinguishing malignant from benign lymphadenopathies in patients presenting with lymphadenopathies. A thorough evaluation of the duration, localisation, distribution, size and consistency of lymphadenopathies reduce unnecassary time-loss and expenses associated with the diagnostic process. Key words : Peripheral lymphadenopathies, childhood cancer.