Evaluation of patients who applied to pediatric hematology-oncology clinic due to peripheral lymphadenopathy

INTRODUCTION AND OBJECTIVE: Peripheral lymphadenopathy is a common finding in childhood and its etiology is often benign, however, it can sometimes be the first sign of serious diseases. We aimed to determine the etiology of children presenting with peripheral lymphadenopathy by evaluating them in accordance with the algorithm we have created with anamnesis, physical examination, laboratory and imaging methods. MATERIAL and METHOD: Patients aged 0 to 18 years who were admitted to the Pediatric Hematology and Oncology Outpatient Clinic of Sakarya University Medical Faculty Training and Research Hospital between 01.07.2019 and 01.06.2020 due to lymph node enlargement were prospectively analyzed. The patients were evaluated according to the algorithm and the information of the cases were recorded in a form (See Appendix 1,2). The characteristics of the most common diagnoses were compared with each other. RESULTS: One hundred sixty five patients with lymphadenopathy were examined and 111 of these cases (67.3%) were found to be male and 54 (32.7%) to be female. The median age was 65 months (minimum 6 months, maximum 213 months). Thirty seven percent of the patients had acute onset at admission. The most common diagnoses were viral lymphadenitis (51.5%), reactive lymphadenopathy (31.5%) and bacterial lymphadenitis (8%). The rate of malignant cases were 2.4%. Most of the reactive LAPs (90.6%) were subacute or chronic. One hundred forty one (86%) patients had LAP in the head and neck region only. The mean diameter of the lymph node of the cases was 2.3±1.1 cm. The rate of the tender LAP was higher in bacterial lymphadenitis (30.8%). Splenomegaly was more prominent in viral lymphadenitis (21.4%). Lymph node biopsy was performed in 22 (13.3%) patients. The most frequent biopsy results were reactive lymphadenopathy (31.8%). CONCLUSION: In our study, infectious causes were the most common etiology of peripheral lymphadenopathy. Biopsy indication was made in 13% of the cases, and malignancy was found in only 2.4% of them. Approximately 90% of the cases could be diagnosed without the need for biopsy with the algorithm we applied. Keywords: Childhood, Lymphadenitis, Peripheral lymphadenopathy.