An approach to cervical lymphadenopathy in children

Abstract

Lymphadenopathy is defined as the presence of one or more lymph nodes of more than 1 cm in diameter, with or without an abnormality in character. (1) In children, it represents the majority of causes of neck masses, which are abnormal palpable lumps or swellings.

Approach to goitre in family medicine practice

“…Inflammatory causes from cervical lymphadenopathy can be attributed to either infective or non-infective causes. [ 4 ] Submental cervical lymphadenitis tends to be associated with infections of the lip, floor of the mouth and skin of the cheeks. The referral for imaging and evaluation should be considered in patients with persistent lymphadenopathy despite 6 weeks of monitoring or suspected bacterial lymphadenopathy with worsening symptoms despite initial antibiotic treatment.…”

Association between the Clinical, Laboratory and Ultrasound Characteristics and the Etiology of Peripheral Lymphadenopathy in Children

“…Localized lymphadenopathy is defined as an abnormality of lymph nodes in only one region (e.g., cervical, inguinal, axillary) and can be unilateral or bilateral. Lymphadenopathy is generalized when lymph nodes are affected simultaneously in two or more noncontiguous regions [1,2].…”

“…No investigation is needed in children with acute bilateral cervical or generalized lymphadenopathy associated with evident viral infection. Even unexplained localized lymphadenopathy without other risk factors for malignancy (see above) can be safely managed by two to three weeks of observation with or without antibiotic treatment [2,3,16].…”

“…Blood tests, such as complete blood count (CBC) with differential, erythrocyte sedimentation rate and C-reactive protein (CRP), are commonly performed in children with lymphadenopathy [2,17]. Ultrasound (US) is useful for differentiating lymphadenopathy from other causes of neck or groin lump and for diagnosing abscess formation in bacterial lymphadenitis.…”

“…Biopsy is performed much earlier in children with unexplained lymphadenopathy and worrisome features. Fine needle aspiration biopsy with cytological and microbiological analysis can be performed instead of excision [2,4,20].…”