The Joint Pathology Center, Silver Spring, MD, USA.
University of Virginia Health System, Charlottesville, VA, USA.
Head Neck Pathol. 2021 Mar;15(1):41-58. doi: 10.1007/s12105-020-01257-6. Epub 2021 Mar 15.
Lymphoid and histiocytic lesions of the head and neck in pediatric patients is a fascinating topic as most of these lesions are benign, but that the neoplastic cases are essential to diagnose accurately for appropriate treatment. It is thought that 90% of children will have palpable lymph nodes between the ages of 4 to 8; most, but not all, are non-malignant and some resolve spontaneously without treatment. This paper will look at many of the benign and malignant lesions of both lymphocytic and histiocytic origin that present in the head and neck of children focusing on their diagnostic criteria. There is a very pertinent discussion of nonmalignant lymphoid proliferations, as infections and other reactive conditions dominate the pathology of pediatric lymphohistiocytic head and neck lesions. Discussion of those lymphomas which arise more frequently in the head and neck focuses on those seen in children and young adults such as classic Hodgkin lymphoma and Burkitt lymphoma, as well as new more controversial entities such as pediatric-type follicular lymphoma. Histiocytic lesions, both benign and malignant, are described and may be challenging to diagnose.
儿童头颈部淋巴和组织细胞病变是一个很有意思的课题，因为这些病变大多数是良性的，但肿瘤性病变对于准确诊断和恰当治疗至关重要。据认为，90%的儿童在 4 至 8 岁之间会有可触及的淋巴结；大多数（但并非全部）是非恶性的，有些无需治疗即可自发消退。本文将探讨许多发生在儿童头颈部的淋巴细胞和组织细胞来源的良性和恶性病变，重点介绍其诊断标准。本文还非常详细地讨论了非恶性淋巴增生，因为感染和其他反应性疾病在儿童头颈部淋巴组织细胞病变的病理中占主导地位。本文还讨论了更常见于头颈部的淋巴瘤，重点介绍了儿童和青年中更常见的淋巴瘤，如经典霍奇金淋巴瘤和伯基特淋巴瘤，以及新出现的更具争议性的实体，如儿童型滤泡性淋巴瘤。本文还描述了良性和恶性组织细胞病变，这些病变的诊断可能具有挑战性。
