Bozlak Serdar, Varkal Muhammet Ali, Yildiz Ismail, Toprak Sadik, Karaman Serap, Erol Oguz Bülent, Yekeler Ensar, Unuvar Ayşegul, Kilic Ayse, Oguz Fatma, Unuvar Emin
Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Istanbul, Turkey.
Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Ambulatory Pediatrics, Istanbul, Turkey.
Int J Pediatr Otorhinolaryngol. 2016 Mar;82:81-7. doi: 10.1016/j.ijporl.2016.01.002. Epub 2016 Jan 12.
Cervical lymphadenopathy (LAP) is a common sign and may raise fears about serious illnesses. The aim of our study was to evaluate the patients with cervical LAPs in a general pediatrics clinic setting, and to evaluate follow-up results for potential causes and risk factors for malignancies.
Two hundred-eighteen patients aged between 79.4±46.7 months with LAP were enrolled in this prospective cohort study. The patients were examined in terms of demographics, clinical, radiologic and serologic aspects like Epstein-Barr virus (EBV), cytomegalovirus (CMV), parvovirus B19. A lymph node biopsy was performed in selected patients. The patients were followed-up for 8 weeks and risk factors for malignancy were evaluated.
Seventy patients (41.3%) had specific etiology and 6 (2.7%) had malignant causes. The causes were as follows: 27% (n=59) infections; 2.7% (n=6) malignancies; 11.4% (n=25) other causes. EBV was responsible for 27% of infectious causes. The other common infectious etiologies were CMV 4.3%, parvovirus B-19 2.9%, and group-A beta-hemolytic streptococcus (GAS) 10.8%. Four of the six malignancies were lymphomas. Predictive factors for malignancy were having LAP larger than 30mm, rubbery lymph node, high serum CRP and LDH values, no hilum in ultrasonography, and enlargement of lymph node in follow-up. High uric acid levels and leucopenia were also common in the malignancy group.
Etiology of cervical LAPs was diagnosed in 41.3% patients. Infectious causes were the most common cause with 27%. Malignancy was diagnosed in 2.7% and lymphoma was the most common malignancy.
颈部淋巴结病是一种常见体征，可能引发对严重疾病的担忧。本研究旨在评估普通儿科门诊环境中患有颈部淋巴结病的患者，并评估潜在病因及恶性肿瘤风险因素的随访结果。
本前瞻性队列研究纳入了218例年龄在79.4±46.7个月之间的颈部淋巴结病患者。从人口统计学、临床、放射学和血清学方面对患者进行检查，如检测爱泼斯坦 - 巴尔病毒（EBV）、巨细胞病毒（CMV）、细小病毒B19。对部分患者进行了淋巴结活检。对患者进行了8周的随访，并评估了恶性肿瘤的风险因素。
70例患者（41.3%）有特定病因，6例（2.7%）有恶性病因。病因如下：感染占27%（n = 59）；恶性肿瘤占2.7%（n = 6）；其他原因占11.4%（n = 25）。EBV占感染病因的27%。其他常见感染病因包括CMV占4.3%、细小病毒B - 19占2.9%、A组β溶血性链球菌（GAS）占10.8%。6例恶性肿瘤中有4例为淋巴瘤。恶性肿瘤的预测因素包括淋巴结直径大于30mm、橡皮样淋巴结、血清CRP和LDH值高、超声检查无淋巴结门部、随访中淋巴结增大。高尿酸水平和白细胞减少在恶性肿瘤组中也很常见。
41.3%的颈部淋巴结病患者病因得以确诊。感染是最常见病因，占27%。恶性肿瘤确诊率为2.7%，淋巴瘤是最常见的恶性肿瘤。
