Role of Lymph Node Biopsy in the Diagnosis of Children with Lymphadenopathy (Single Surgeon Experience)

Abstract

ABSTRACT:BACKGROUND:Assessment of lymphadenopathy in children represents a diagnostic challenge because of the extensive differential diagnoses, including reactive and malignant conditions.OBJECTIVE:To determine the role of lymph node biopsy in the diagnosis of lymphadenopathy in paediatrics age groupPATIENTS AND METHODS:A cross sectional study was carried out on 92 patients (males 56 and 36 females) with lymphadenopathy admitted to paediatric surgery unit at Children Welfare Teaching Hospital – Medical City Complex – Baghdad in the period between January 1st. 2010 to December 31st. 2016; for biopsy to reach final diagnosis.Patients were referred from general wards, paediatrics outpatient clinic and oncology unit.Data regarding patient name, age, gender, signs and symptoms, site of lymph nodes, size of lymph node, duration of enlargement, investigation, types of biopsy, and mode of treatment were collected and reviewed form patients files.All patients underwent excisional biopsy and the diagnosis was confirmed by histology and through various specific investigations.RESULTS: Among the total 92 lymph node biopsies, the most common pathology encountered was reactive hyperplasia in 68 child (74 %) followed by malignant lymphoma (Non- Hodgkin and Hodgkin) in 15 children (16.3%), followed by tuberculosis in 3 (3.3%).The rest of the lesions include: 1 case of granulomatous lymphadenitis (1%), 2 of histiocytosis X (2%), 2 (2%) of rhabdomyosarcoma, and 1 of germ cell tumour (1%).Common site of lymph node enlargement was cervical in (97%) of patients.CONCLUSION: Cervical lymphadenopathy is a common condition in the paediatric age group. In spite that most common cause of lymphadenopathy was reactive hyperplasia. Lymph node biopsy remains an important diagnostic tool in persistent lymph node enlargement and if malignancy is suspected. .