Ritchey A K
Department of Pediatrics, West Virginia University Health Sciences Center, Morgantown.
W V Med J. 1990 Sep;86(9):402-4.
Lymphadenopathy is commonly found in sick children and the cause of the enlarged nodes is usually evident. However, lymphadenopathy of a prolonged duration or with larger than anticipated nodes often presents a diagnostic dilemma. Knowledge of the normal pattern of lymph node size in children and the mechanisms of lymphadenopathy are prerequisites to approaching the diagnosis. Historical and physical clues help to guide the diagnostic evaluation and may indicate the need for certain laboratory tests, a trial of antibiotics, immediate biopsy, or simply close observation. If a biopsy is performed, comprehensive evaluation of the lymph node is critical to the diagnosis and subsequent treatment. Although most children with peripheral adenopathy have reactive hyperplasia of unknown etiology, it is important to monitor children with persistent lymphadenopathy until a diagnosis is made or the adenopathy resolves.
淋巴结病在患病儿童中很常见，肿大淋巴结的病因通常很明显。然而，持续时间较长或淋巴结比预期大的淋巴结病常常带来诊断难题。了解儿童淋巴结大小的正常模式以及淋巴结病的机制是进行诊断的先决条件。病史和体格检查线索有助于指导诊断评估，并可能提示是否需要进行某些实验室检查、试用抗生素、立即活检或仅仅是密切观察。如果进行活检，对淋巴结进行全面评估对诊断和后续治疗至关重要。虽然大多数外周淋巴结病患儿有病因不明的反应性增生，但对持续存在淋巴结病的患儿进行监测直到确诊或淋巴结病消退很重要。
