Evaluation of childhood lymphadenopathy cases

INTRODUCTION AND OBJECTIVE: Lymphadenopathy (LAP) in childhood; is defined as a change in lymph node size or deterioration in its structure; which is often seen due to benign causes. Our aim is to determine the etiology and clinical course of patients who applied for cervical LAP by retrospectively evaluating the results of their anamnesis, physical examination findings, laboratory tests and imaging methods, as well as to evaluate the differential diagnosis, duration of follow-up and final status. MATERIALS AND METHODS: In our study, we retrospectively evaluated 204 patients who applied to Afyonkarahisar Healt Sciences University Pediatric Hematology and Oncology outpatient clinic due to cervical LAP between 01.01.2015 and 01.08.2020. By evaluating the history, physical examination, laboratory, advanced serology and imaging methods, benign/malign distinction was made between the patients who applied, and biopsy was performed in case of clinical necessity. RESULTS: Of the 204 patients who applied for cervical LAP, 65 (32,5%) were female and 135 (67,5%) were male, and non-LAP was found in 4 patients. Of the admitted patients, 20% has an acute course, 16% had a chronic course and the rest had a subacute course. At least one of the pathological features such as tenderness, redness, hardness, rubbery consistency and conglomeration was detected in 22,5% of the patients. B symptoms accompanied the clinic in 9% of the patients. LAP size over 3 cm, fixed LAP, hard or rubbery in consistency, conglomeration, and roundness were found to be statistically significantly associated with malignancy. In addition, the presence of B symtoms in the history, hepatosplenomegaly on physical examination, unresponsiveness to antibiotic therapy, and increased LAP size in the follow-up were also found to be associated with malignancy. In logistic regression analysis, it was determined that conglomeration increased the risk of malignancy 11,315 times. CONCLUSION: Anamnesis taken at the time of admission, physical examination, laboratory tests performed in case of clinical necessity, and imaging methods from patient followed up for cervical LAP lead to diagnosis. In particular, the size, mobility status, extent, consistency, accompanying systemic findings, which we call pathological LAP, guide the differentiation of benign/malignant LAP. Conglomeration is one of the most important examination findings that can be used to differentiate benign / malignant LAP. Key words: cervical lymphadenopathy, conglomeration, malignant, pathological LAP