Sarsu Sevgi Buyukbese, Sahin Kamil
Department of Paediatric Surgery, Gaziantep Children's Hospital, Gaziantep, Turkey.
Department of Paediatrics, Haseki Training and Research Hospital, Istanbul, Turkey.
J Pak Med Assoc. 2016 Jun;66(6):654-7.
To determine the causes of lymphadenopathies in children living in our region, and detect the frequency of malignant disease.
Our study evaluated demographic characteristics, lymph node involvement sites, tests, and viral serologiesperformed to search for the presence of infection, and ultrasonographic, and histologic findings of 1700 children who were referred to the outpatient clinics of the Paediatric Diseases and Paediatric Surgery between January 2012, and January 2015.
Our study population consisted of 1003 (59 %) boys, and 697 (41 %) girls aged less than 18 years.Definitive diagnosis of43 (8.68 %) patients with unilateral, and 452 (91.9 %) cases with bilateral lymphadenopathies was established. These cases had benign (n=455) , and malignant (n=40) etiologies. Two hundred and four (12 %) of them underwent biopsies. On histological evaluation TB (n=6), Kawasakisyndrome (n=3), catscratch syndrome (n=4), toxoplasmosis (n=17), sarcoidosis (n=22), non-Hodgkinlymphoma (n=23),Hodgkin lymphoma (n=15), and Langerhans cell histiocytosis (n=2) were detected. Histological examination of the biopsy specimens of 110 cases revealed nonspecific histological changes. A total of 1205 (70.88%) patients without definitive diagnosis had undergone ultrasonographic assessments, and clinical evaluations performed before or within 4 weeks after antibiotic therapy and revealed regression of the lesions.
The most widely encountered cause of lymphadenopathy is infection. Most of them are secondary to nonspecific viral, and bacterial infections. Most frequently diagnosed viral infections are caused by cytomegalovirus (CMV), and Ebstein-Barr virus (EBV). The most important issue in patients presenting with complaints of lymphadenopathy is the detection of the underlying malignant disease (if any), with the most frequent being non-Hodgkin lymphoma. Excisional biopsy is still the gold standard diagnostic method. Although our hospital was not an oncology center, our malignancy rate was higher than seen in some series. This might be possibly due to referral of monitored patients to our regional hospital for biopsy.
确定我们地区儿童淋巴结病的病因，并检测恶性疾病的发生率。
我们的研究评估了2012年1月至2015年1月期间转诊至儿科疾病和小儿外科门诊的1700名儿童的人口统计学特征、淋巴结受累部位、检查、用于寻找感染存在的病毒血清学检查，以及超声和组织学检查结果。
我们的研究人群包括1003名（59%）年龄小于18岁的男孩和697名（41%）女孩。确诊了43例（8.68%）单侧淋巴结病患者和452例（91.9%）双侧淋巴结病患者。这些病例有良性（n = 455）和恶性（n = 40）病因。其中204例（12%）接受了活检。组织学评估发现结核（n = 6）、川崎综合征（n = 3）、猫抓病（n = 4）、弓形虫病（n = 17）、结节病（n = 22）、非霍奇金淋巴瘤（n = 23）、霍奇金淋巴瘤（n = 15）和朗格汉斯细胞组织细胞增多症（n = 2）。110例活检标本的组织学检查显示非特异性组织学改变。共有1205例（70.88%）未确诊的患者接受了超声评估，并在抗生素治疗前或治疗后4周内进行了临床评估，结果显示病变消退。
淋巴结病最常见的病因是感染。其中大多数继发于非特异性病毒和细菌感染。最常诊断出的病毒感染是由巨细胞病毒（CMV）和爱泼斯坦 - 巴尔病毒（EBV）引起的。出现淋巴结病症状的患者最重要的问题是检测潜在的恶性疾病（如果有的话），最常见于非霍奇金淋巴瘤。切除活检仍然是金标准诊断方法。虽然我们医院不是肿瘤中心，但我们的恶性肿瘤发生率高于一些系列报道。这可能是由于将监测患者转诊到我们地区医院进行活检所致。
