Peripheral Lymphadenopathy in Childhood: Single Center Study

Purpose: Lymphadenopathy is defined as an abnormality in the size and/or character of lymph node. In this study we aimed to describe the clinical and laboratory findings of benign and malignant causes of peripheral lymphadenopathy in childhood. Material and Methods: Two hundred and twenty four patients who were admitted to the clinic with peripheral LAP were evaluated. Age, gender, laboratory and radiologic findings, final diagnoses, and duration, localization, size, consistency, spread, and accompanying local and systemic symptoms of LAP were determined. Benign and malignant causes of peripheral lymphadenopathy were compared. Results: One hundred twenty-six patients (56.0%) were male and 98 patients (44.0%) were female. After the first evaluation the patients were divided into two groups. The first group included 186 patients with benign causes and the second group included 38 patients with malignant causes. One hundred and sixty four of 224 patients (73.2 %) had localized peripheral lymphadenopathy. The most frequent cause of localized lymphadenopathy in the benign group was acute lymphadenitis (34.8%). The most common cause of localized lymphadenopathy in the malignant group was Hodgkin's lymphoma (4.3%). Sixty of 224 (26.8%) patients had generalized peripheral lymphadenopathy. The most significant cause of generalized lymphadenopathy in the benign lymphadenopathy group was Epstein-Barr virus (10.0%), whereas Hodgkin's lymphoma (23.3%) was the most common cause in malign lymphadenopathy group. Localized and generalized lymph node enlargement was most frequently found in cervical region. The most frequent site of involvement among benign and malignant cases was the cervical area. The results revealed that findings such as chronic course, generalized LAP, supraclavicular, cervical and inguinal location, organomegaly, hilier LAP, abdominal LAP, and abnormal laboratory findings (thrombocytopenia and blasts on the peripheral blood smear) were associated with malignant diseases. Conclusion: Infections are the most common cause of peripheral LAP. The risk of malignany increases with the age of child and the duration of LAP. Older children with chronic LAP, generalized LAP associated with organomegaly, abnormal laboratory findings should be considered as malignant LAP