Niedzielska Grazyna, Kotowski Michal, Niedzielski Artur, Dybiec Ewa, Wieczorek Pawel
Department of Pediatric Otolaryngology, Phoniatrics and Audiology, Medical University of Lublin, ul. Chodzki 2, 20-093 Lublin, Poland.
Int J Pediatr Otorhinolaryngol. 2007 Jan;71(1):51-6. doi: 10.1016/j.ijporl.2006.08.024. Epub 2006 Nov 9.
Palpable lymph nodes are common due to the reactive hyperplasia of lymphatic tissue mainly connected with local inflammatory process. Differential diagnosis of persistent nodular change on the neck is different in children, due to higher incidence of congenital abnormalities and infectious diseases and relative rarity of malignancies in that age group. The aim of our study was to analyse the most common causes of childhood cervical lymphadenopathy and determine of management guidelines on the basis of clinical examination and ultrasonographic evaluation.
The research covered 87 children with cervical lymphadenopathy. Age, gender and accompanying diseases of the patients were assessed. All the patients were diagnosed radiologically on the basis of ultrasonographic evaluation.
Reactive inflammatory changes of bacterial origin were observed in 50 children (57.5%). Fever was the most common general symptom accompanying lymphadenopathy and was observed in 21 cases (24.1%). The ultrasonographic evaluation revealed oval-shaped lymph nodes with the domination of long axis in 78 patients (89.66%). The proper width of hilus and their proper vascularization were observed in 75 children (86.2%). Some additional clinical and laboratory tests were needed in the patients with abnormal sonographic image.
Ultrasonographic imaging is extremely helpful in diagnostics, differentiation and following the treatment of childhood lymphadenopathy. Failure of regression after 4-6 weeks might be an indication for a diagnostic biopsy.
可触及的淋巴结很常见，主要是由于与局部炎症过程相关的淋巴组织反应性增生。儿童颈部持续性结节性病变的鉴别诊断有所不同，因为该年龄组先天性异常和传染病的发病率较高，而恶性肿瘤相对少见。我们研究的目的是分析儿童颈淋巴结病最常见的病因，并根据临床检查和超声评估确定管理指南。
该研究涵盖了87例颈淋巴结病患儿。评估了患者的年龄、性别及伴随疾病。所有患者均在超声评估的基础上进行了放射学诊断。
50名儿童（57.5%）观察到细菌性起源的反应性炎症变化。发热是伴随淋巴结病最常见的全身症状，21例（24.1%）出现发热。超声评估显示78例患者（89.66%）的淋巴结呈椭圆形，长轴为主。75名儿童（86.2%）观察到淋巴结门的适当宽度及其适当的血管形成。超声图像异常的患者需要进行一些额外的临床和实验室检查。
超声成像在儿童淋巴结病的诊断、鉴别和治疗随访中非常有帮助。4-6周后未消退可能是诊断性活检的指征。
