Peripheral lymphadenopathy in childhood. Ten-year experience with excisional biopsy.

We reviewed our experience with excisional lymph node biopsy over a ten-year period in an attempt to determine which clinical features, if any, were predictive of histologic diagnosis. A total of 75 patients, aged 8 months to 17 years, were available for review. Of these patients, 41 (55%) had nodes with nondiagnostic hyperplasia, 16 (21%) had noncaseating granulomatous lymphadenitis, 5 (7%) showed the caseating lesion of tuberculosis, while 13 (17%) showed a lymphoreticular malignant neoplasm. While patients with lymphoma more frequently had a history of weight loss or arthralgia, no one clinical feature, by either its presence or absence, could predict the biopsy diagnosis. All five patients with supraclavicular lymhadenopathy were found to have mediastinal disease. Of the 41 patients initially found to have nondiagnostic reactive hyperplasia, seven (17%) ultimately proved to have a specific pathologic process.