Publication:

Clinicopathological profile of significant cervical lymphadenopathy in children

Background In children enlarged cervical lymph nodes is one of the common presentations and requires evaluation. The aetiology of cervical lymphadenopathy can be either due to benign self-limiting conditions (viral or bacterial infection) or due to some serious systemic diseases like tuberculosis or malignancy. This study intends to analyse wide etiological presentations of cervical lymphadenopathy in children with cytopathological correlation by fine needle aspiration cytology (FNAC) for timely diagnosis and if required to refer early for further management.

Methods This is a hospital based prospective observational study conducted at department of Paediatrics at IGICH, Bengaluru among children between 1 month-18 years of age with significant cervical lymphadenopathy.

Results Total of 100 cases of significant cervical lymphadenopathy were included in the study. Most common age group involved was between 4-8 years with male preponderance (M:F=1.5:1). Fever and swelling in the neck were the most common presenting complaints. After investigation, reactive lymphadenitis (55%) was the most common aetiology among which tonsillitis (38%) and otitis media (11%) were most common. Second most common aetiology was tuberculosis (30%). Five (5%) patients had malignancy. Sensitivity of FNAC in detecting tuberculosis (TB) lymphadenitis was found to be 90.9% in this study.

Conclusions Cervical lymphadenopathy is one of the common clinical conditions which paediatricians face in daily practice that requires detailed evaluation for accurate diagnosis and treatment. Reactive lymphadenitis and tubercular lymphadenitis remain the most common aetiologies. Presently FNAC has emerged as important tool in the initial diagnosis and management of patients with lymphadenopathy.