Evaluation of peripheral lymphadenopathy in children
Evaluation of peripheral lymphadenopathy in children
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DOI：
10.1080/08880010600856907
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发表时间：
2006-10-01
影响因子：
1.7
通讯作者：
Okur, F. Visal
中科院分区：
文献类型：
--
作者：
Oguz, Aynur;Karadeniz, Ceyda;Okur, F. Visal
本研究的目的是评估儿童淋巴结病和临床方法怀疑恶性肿瘤。作者评价了457例周围淋巴结病患者，年龄小于19岁，并在1996年3月至2004年4月期间转诊至Gazi大学医学院儿科肿瘤科。共有346名患者患有良性疾病，111名患有恶性病变。对134例患者进行了切除活检。良性组有特异性病因者占39%。457例患者中，218例表现为急性淋巴结病，其余为慢性淋巴结病。在急性淋巴结病组中，98.2%的患者具有良性病因。恶性病变多表现为慢性淋巴结病。关于扩展，193例患者有局限性淋巴结病，264例患者有全身性淋巴结病。局限性和全身性淋巴结病组均以颈部最常见。恶性肿瘤表现为全身淋巴结病。锁骨上区仅见于恶性组。腋窝受累在卡介苗相关淋巴结炎和结核分枝杆菌中占主导地位。小于1cm的淋巴结均为良性。恶性病变直径多在3cm以上。以下结果应提醒儿科医生恶性疾病的可能性：淋巴结肿大超过3 cm，持续时间超过4周，锁骨上受累，实验室和放射学异常。
The aim of this study was to evaluate children with lymphadenopathy and clinical approach to the suspicion of malignancy. The authors evaluated 457 patients with peripheral lymphadenopathy, less than 19 years of age, and referred to the Pediatric Oncology Department of Gazi University Medical School during the periods March 1996-April 2004. A total of 346 patients had benign disorders and 111 had malignant pathologies. Excisional biopsies were performed to 134 patients. A specific etiology could be found 39% in the benign group. Of the 457 patients, 218 were presented as acute, the rest as chronic lymphadenopathy. In the acute lymphadenopathy group, 98.2% of the patients had benign etiologies. The malignant disorders were mostly represented as chronic lymphadenopathy. Concerning the extension, 193 patients had localized lymphadenopathy and 264 had generalized lymphadenopaties. Cervical region was the most frequent site in both localized and generalized lymphadenopathy groups. Malignancies occurred as generalized lymphadenopathy. Supraclavicular area were involved only in the malignant group. Axillary involvement was predominant in BCG vaccine associated lymphadenitis and mycobacterium tuberculosis. All the lymph nodes less than 1 cm were due to benign causes. The malignant lesions were usually more than 3 cm in diameters. The following findings should alert the pediatrician for the probability of a malignant disorder: lymphadenopathy of more than 3 cm in size, of more than 4 weeks in duration, with supraclavicular involvement, and with abnormal laboratory and radiological findings.