Pediatric Cervical Lymphadenopathy

Rosenberg, Tara L.; Nolder, Abby R.

doi:10.1016/j.otc.2014.06.012

Cited by 56 publications

(53 citation statements)

References 29 publications

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“…Concerning findings that may suggest malignancy include nodes that are rapidly enlarging, are nontender, and are fixed to the skin or underlying structures. Also, generalized lymphadenopathy, supraclavicular nodes regardless of size, lower cervical nodes, increased patient age, lymph nodes greater than 2 to 3 cm, and hepatosplenomegaly are associated with increased risk of malignancy [3,22,23,24]. Associated systemic symptoms, such as weight loss, night sweats, unexplained fever, or fatigue should initiate further workup for possible malignancy or chronic inflammatory conditions [25,26].…”

Section: Discussionmentioning

confidence: 99%

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Streptococcal carriage in children with cervical lymphadenopathy

2018

Ann Clin Anal Med

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Aim: To demonstrate the rate of streptococcal carriage in children with unexplained cervical lymphodenopathy (LAP) with clinical examination and ultrasonographic findings as well as by throat culture. Material and Method: A total of 90 children (45 patients and 45 control groups) were included in the study. All the patients were diagnosed radiologically on the basis of ultrasonographic evaluation. Pediatric patients who were followed up for at least 6 weeks for cervical LAP and whose LAP size was greater than 1 cm were studied. Throat culture and anti-streptolysin O titer (ASOT) was ordered for the patient and control groups. Results: LAP size was measured as minimum 20*5 mm and maximum 35*8 mm in US guided measurements. Bacterial reproduction was detected in 13 (28.9%) patients and only in one control subject (2.2%), which was statistically significant. The mean ASOT was found to be lower in the study group (ASOT: 90.70 IU/mL) and higher in the control group (ASOT: 208.00 IU/mL), but no significant difference was found between the groups (p=0.113). Discussion: Throat culture is a non-invasive test, but requires other tests for definitive diagnosis. In our study, bacterial reproduction detected in throat culture correlated with unexplained cervical LAP.

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Section: Discussionmentioning

confidence: 99%

“…However, when is detected over two years of age, a clarifying diagnostic finding is quite rare [2]. The most common are infective or inflammatory LAPs; malignancy is very rare.…”

mentioning

confidence: 99%

Streptococcal carriage in children with cervical lymphadenopathy

2018

Ann Clin Anal Med

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“…Enlarged cervical lymph nodes are the most common palpable neck masses in the pediatric population as 80–90% of the children between 4 and 8 years have palpable cervical lymph nodes …”

Section: Acquired Solid Massesmentioning

confidence: 99%

“…The bilateral submandibular and upper internal jugular lymph nodes are typically involved. In case of bacterial infection, unilateral lymph node involvement is frequently noted . US is the imaging method of choice to identify reactive lymphadenopathy and possible complications including suppurative inflammation or abscess formation.…”

Section: Acquired Solid Massesmentioning

confidence: 99%

“…Enlarged cervical lymph nodes are the most common palpable neck masses in the pediatric population as 80-90% of the children between 4 and 8 years have palpable cervical lymph nodes. 60 The most frequent etiology in cervical lymphadenitis is a viral infection of the upper respiratory tract. The bilateral submandibular and upper internal jugular lymph nodes are typically involved.…”

Section: Lymphadenitismentioning

confidence: 99%

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Lumps and Bumps of the Neck in Children—Neuroimaging of Congenital and Acquired Lesions

Dremmen

Tekes

Mueller

et al. 2016

Journal of Neuroimaging

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Neck masses present as palpable lumps and bumps in children with acquired lesions more common than congenital ones. Assessment of the anatomical site of origin, signal, and contrast enhancement characteristics may help define the etiology of the lesions, eg, developmental, inflammatory, vascular, or neoplastic. The age of the patient along with detailed clinical history and physical exam findings are important element to narrow down the differential diagnosis. The correct final diagnosis is essential to guide treatment as well as the urgency of intervention. The objective of this review is to define the characteristic location, classic and differentiating imaging features of the most frequent congenital and acquired cervical lumps and bumps in the pediatric population.

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Management of Pediatric Persistent Asymptomatic Cervical Lymphadenopathy

Harris

Patel

Wai

et al. 2023

Otolaryngol.--head neck surg.

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ObjectivePersistent asymptomatic cervical lymphadenopathy (PACL) is a common outpatient referral diagnosis for pediatric otolaryngologists. Historically, excisional biopsy under general anesthesia has been the gold standard for diagnosis but is associated with some risks. Current literature provides little guidance on less invasive monitoring. Our hypothesis is that the majority of children who present with PACL can be safely monitored with ultrasound and avoid the risks of excisional biopsy.Study DesignA retrospective review was performed of patients <18 years of age, referred to a tertiary care children's hospital for PACL who also underwent at least 1 neck ultrasound from 2007 to 2021. Patients with acute neck infections, congenital masses, or known rheumatologic, immunologic, or malignant conditions were excluded. A multivariate logistic regression model was used to determine patient and nodal factors associated with the decision for operative management.SettingUniversity of California, San Francisco Pediatric Otolaryngology Department.ResultsAmong the 197 patients meeting inclusion criteria, 30 (15.2%) underwent surgical biopsy. Overall, 26% underwent repeat ultrasound with a mean interval of 6.6 months, and a mean decrease in nodal size of 0.34 cm. Of the 30 surgical cases, 27 (90%) patients had benign pathology. Multivariate regression analysis revealed pain (p = .04), firmness (p < .001), and lack of a normal fatty hilum on ultrasound (p = .04) as statistically significantly correlated with decisions for surgical management.ConclusionThe majority of pediatric PACL is benign and does not require an excisional biopsy to rule out lymphoma. Serial clinical follow‐up with neck ultrasound can be used to safely monitor patients.

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Pediatric Cervical Lymphadenopathy

Cited by 56 publications

References 29 publications

Streptococcal carriage in children with cervical lymphadenopathy

Streptococcal carriage in children with cervical lymphadenopathy

Lumps and Bumps of the Neck in Children—Neuroimaging of Congenital and Acquired Lesions

Management of Pediatric Persistent Asymptomatic Cervical Lymphadenopathy

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