Unexplained cervical lymphadenopathy in children: predictive factors for malignancy

Paediatric cervical lymphadenopathy

“…Increased patient age (>10 years), larger lymph node size (>2 cm), multiple sites of adenopathy (>2) and supraclavicular location of adenopathy were all associated with a greater risk of malignancy. Wang et al [13] reviewed 175 cases of unexplained cervical lymphadenopathy and found similar results with respect to lymph node size and multiple sites of adenopathy. Fever, weight loss, night sweats and duration of lymphadenopathy have not been shown to be predictive of malignancy but should be taken into consideration when making the decision for biopsy [1,6,13,14].…”

“…Wang et al [13] reviewed 175 cases of unexplained cervical lymphadenopathy and found similar results with respect to lymph node size and multiple sites of adenopathy. Fever, weight loss, night sweats and duration of lymphadenopathy have not been shown to be predictive of malignancy but should be taken into consideration when making the decision for biopsy [1,6,13,14]. Lymphoma (Hodgkin and non-Hodgkin), leukaemia, neuroblastoma and rhabdomyosarcoma were the most common malignant diagnoses found in these retrospective reviews [1,[12][13][14], which is consistent with previous reports [3 & ,7,11].…”

“…Although the majority of these lymph node biopsies will be benign, with reactive hyperplasia being the most common histologic diagnosis [6,[11][12][13][14], the possibility of malignancy often drives the decision for biopsy. Risk of malignancy may be increased if certain patient and lymph node characteristics are present.…”

“…Fever, weight loss, night sweats and duration of lymphadenopathy have not been shown to be predictive of malignancy but should be taken into consideration when making the decision for biopsy [1,6,13,14]. Lymphoma (Hodgkin and non-Hodgkin), leukaemia, neuroblastoma and rhabdomyosarcoma were the most common malignant diagnoses found in these retrospective reviews [1,[12][13][14], which is consistent with previous reports [3 & ,7,11]. The combination of these predictive factors combined with other suspicious physical examination and imaging findings should prompt the physician to consider early biopsy for definitive diagnosis.…”

Predictive factors for malignancy in patients with persistent cervical lymphadenopathy

“…This model had a sensitivity of 30.5 %, a specificity of 97.1 %, and an accuracy of 85.6 % [12]. Wang et al [13] found that higher width-length ratio, involvement of multiple cervical regions, and region II (levels II and III) or III (levels IV and V) location of the largest node are associated with malignancy. Matsumoto et al [14] performed cervical lymph node biopsy on 60 non-cancer patients and found that serum levels of lactate dehydrogenase, interleukin 2 receptor levels, age and lymph node size in the malignant lymphoma group were significantly higher than in the benign group.…”