How to use… lymph node biopsy in paediatrics

Farndon, Sarah J.; Behjati, Sam; Jonas, Nico; Messahel, Boo

doi:10.1136/archdischild-2015-309634

Cited by 10 publications

(9 citation statements)

References 17 publications

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“…4,5,12,13 Asimismo, en los siete pacientes que se identificó alguna neoplasia, el tipo específico es el que con más frecuencia se ha descrito previamente, como los linfomas, sarcomas y la histiocitosis de células de Langerhans. 7,14 La principal limitación de este trabajo es que se trata de un estudio retrospectivo, a partir de la información descrita en expedientes clínicos, lo cual pudo haber influido en tener una mayor proporción de pacientes con alguna neoplasia, comparado con estudios previos. Además, la falta de datos específicos de la exploración física, de síntomas clínicos, del tipo de tratamiento recibido antes de la biopsia, o bien, de los resultados de los estudios de laboratorio hubieran sido relevantes para tratar de brindar orientación a los médicos para seleccionar de mejor manera a los pacientes que requieren realizar biopsias ganglionares.…”

Section: Discussionunclassified

“…La biopsia es considerada el estándar de oro para el diagnóstico de las adenopatías, pero tiene desventajas al ser un procedimiento invasivo, porque se requiere de anestesia y ocasionar lesiones a nervios, sangrados o infecciones. 7 En estudios previos se ha descrito que los hallazgos más frecuentes en biopsias ganglionares son: hiperplasia reactiva (52%), enfermedad granulomatosa (36.3%), enfermedad neoplásica (8.2%), dermatosis (3%), o infección bacteriana (3%). 8 En otro estudio, en Costa Rica, al incluir preescolares entre cuatro y ocho años, lo más frecuente fue: hiperplasia reactiva (54%), adenitis bacteriana (19%) y linfadenitis toxoplásmica (13%).…”

Section: Wwwmedigraphicorgmx Introducciónunclassified

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Características clínicas e histopatológicas de las adenopatías en pediatría. Análisis de 10 años en un hospital privado

Guevara-Méndez¹,

Hernández-Benítez²,

Iglesias-Leboreiro³

et al. 2022

Revista Mexicana De Pediatría

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Section: Discussionunclassified

Section: Wwwmedigraphicorgmx Introducciónunclassified

Características clínicas e histopatológicas de las adenopatías en pediatría. Análisis de 10 años en un hospital privado

Guevara-Méndez¹,

Hernández-Benítez²,

Iglesias-Leboreiro³

et al. 2022

Revista Mexicana De Pediatría

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“…Cancerous tumor development is also less frequently seen in mobile, soft LAPs less than 2.5-3 cm in size, in the patients with cervical location, and without concomitant severe systemic signs and symptoms. [1][2][3][4][5][6][7][8][9][10] Patients should be adequately evaluated for these features and oncology consultation should be requested in case of doubt. In our study, only three patients (2%) had extensive lymph node involvement and 85.5% of the regional lymph nodes were located in the cervical or submandibular regions.…”

Section: Discussionmentioning

confidence: 99%

“…Although US is not routinely recommended for the diagnosis and followup of LAPs, most of which are reactive, and frequently ultrasonographic examinations were performed in studies conducted in our country with reported rates ranging between 50 and 70%. [1][2][3][4][5][6][7][8][9][10][11][12][13] Requesting US in primary care without adequate clinical evaluation of the patients and inadequate radiological evaluations may lead to unnecessary referral of the patients to oncology.…”

Section: Discussionmentioning

confidence: 99%

Clinical Caharacteristics Of And Cancer Incidence In Children Evaluated For Lymphadenoapthy Referred To Pediatrci Oncology Clinics

Vural¹

2018

Sisli Etfal

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is a common clinical finding in childhood. The lymph node size above the expected limits and/or disruption of its structure is called LAP. Although it varies according to the region where the lymph node is located, lymph nodes that are generally greater than 1-1.5 cm, and in some resources larger than 2.5 cm and/ or deformed structure are considered pathological. LAP is most often seen in response to regional or systemic acute infections and has a good course. Severe diseases, such as chronic infections, rheumatological diseases and rarely childhood cancers, can be included in its etiology. The frequency of cancer among patients who are followed up due to growth in lymph nodes varies according to the centers. In primary care centers, the proportion of patients diag-Objectives: In our study, we aimed to investigate the clinical characteristics and cancer frequency in patients referred to our pediatric oncology outpatient clinic for lymphadenopathy. Methods: The charts of patients admitted to our pediatric oncology outpatient clinics for lymphadenopathy between January 2014, and December 2016 were retrospectively reviewed in this study. Age, gender, duration of complaints, previous therapies, systemic signs and symptoms, lymph node characteristics and laboratory findings were recorded. The frequency of malignancy was calculated. Results: One hundred thirty-four patients (34 girls) with a median age of six years (range four months-17 years) were included in our study. The majority of the patients (98%) had localized lymphadenopathy and the head and neck region was the most common site of involvement (87%). The median long-axis diameter of lymph nodes ranged between 0.5 cm and 5 cm (median 2 cm) by physical examination. Twenty-one patients (15.6%) had lymph node biopsy. Four patients had ruptured epidermal cyst, lymphangioma, pilomatricoma and ectopic thymus. Of the other biopsies, nine patients were diagnosed with reactive LAP, four with lymphadenitis, and four with Hodgkin's disease. The lymphoma patients had lymph node size greater than 2.5 cm and the duration of lymphadenopathy was longer than four weeks. Three out of four patients had systemic clinical findings accompanying lymph node enlargement. Conclusion: Three percent of the patients with lymphadenopathy who were referred for suspected malignancy received a cancer diagnosis. This rate, which is too low for a reference center, suggested that the patients might be referred to the pediatric oncology outpatient clinic without a thorough evaluation in primary health care.

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“…Excisional biopsy is gold standard for histological investigation 9 10. This is because excisional biopsy removes the entire lymph node and thus usually provides sufficient tissue to allow microscopic examination of all regions of the lymph node 11. Although fine-needle aspiration biopsy (FNAB) has a well established role in the evaluation of an adult head and neck mass, it remains under-used in children 12.…”

Section: Commentary: Neck Lumpsmentioning

confidence: 99%

A child in shock: carotid blowout syndrome

Stilwell

Robertson

Bhate

et al. 2019

Arch Dis Child Educ Pract Ed

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Paediatricians commonly encounter neck lumps during their routine clinical practice; vascular abnormalities, such as (pseudo)aneurysms, are a rare cause of these. Pseudoaneurysms of the carotid artery in children are usually the result of blunt or penetrating trauma, infection or vasculitis/connective tissue disorders. They can present with a variety of symptoms including neck pain, as a pulsatile neck mass or with compressive symptoms (for example, cranial nerve palsies or dyspnoea). Pseudoaneurysms carry a risk of rupture in which case they are fatal, unless immediate treatment is provided.We report a 17-month-old male child with idiopathic carotid artery blowout syndrome presenting with acute oropharyngeal haemorrhage leading to asystolic cardiac arrest. He was successfully resuscitated and emergency embolisation controlled the bleeding. Despite extensive left hemispheric infarct, he has survived.Carotid artery blowout syndrome needs to be recognised as a potential cause of major haemorrhage in childhood. The purpose of this case report is to remind readers of the differential diagnosis and work-up of a child presenting with a neck lump, to highlight important aspects of the acute management of major haemorrhage and massive blood transfusion in paediatrics, to describe the aetiology, presentation and management of carotid artery pseudoaneurysm in children and to discuss long term rehabilitation in patients with consequent neurological sequelae (including the need for input from multiple specialty teams).

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How to use… lymph node biopsy in paediatrics

Cited by 10 publications

References 17 publications

Características clínicas e histopatológicas de las adenopatías en pediatría. Análisis de 10 años en un hospital privado

Características clínicas e histopatológicas de las adenopatías en pediatría. Análisis de 10 años en un hospital privado

Clinical Caharacteristics Of And Cancer Incidence In Children Evaluated For Lymphadenoapthy Referred To Pediatrci Oncology Clinics

A child in shock: carotid blowout syndrome

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