Clinical Caharacteristics Of And Cancer Incidence In Children Evaluated For Lymphadenoapthy Referred To Pediatrci Oncology Clinics

Abstract

is a common clinical finding in childhood. The lymph node size above the expected limits and/or disruption of its structure is called LAP. Although it varies according to the region where the lymph node is located, lymph nodes that are generally greater than 1-1.5 cm, and in some resources larger than 2.5 cm and/ or deformed structure are considered pathological. LAP is most often seen in response to regional or systemic acute infections and has a good course. Severe diseases, such as chronic infections, rheumatological diseases and rarely childhood cancers, can be included in its etiology. The frequency of cancer among patients who are followed up due to growth in lymph nodes varies according to the centers. In primary care centers, the proportion of patients diag-Objectives: In our study, we aimed to investigate the clinical characteristics and cancer frequency in patients referred to our pediatric oncology outpatient clinic for lymphadenopathy. Methods: The charts of patients admitted to our pediatric oncology outpatient clinics for lymphadenopathy between January 2014, and December 2016 were retrospectively reviewed in this study. Age, gender, duration of complaints, previous therapies, systemic signs and symptoms, lymph node characteristics and laboratory findings were recorded. The frequency of malignancy was calculated. Results: One hundred thirty-four patients (34 girls) with a median age of six years (range four months-17 years) were included in our study. The majority of the patients (98%) had localized lymphadenopathy and the head and neck region was the most common site of involvement (87%). The median long-axis diameter of lymph nodes ranged between 0.5 cm and 5 cm (median 2 cm) by physical examination. Twenty-one patients (15.6%) had lymph node biopsy. Four patients had ruptured epidermal cyst, lymphangioma, pilomatricoma and ectopic thymus. Of the other biopsies, nine patients were diagnosed with reactive LAP, four with lymphadenitis, and four with Hodgkin's disease. The lymphoma patients had lymph node size greater than 2.5 cm and the duration of lymphadenopathy was longer than four weeks. Three out of four patients had systemic clinical findings accompanying lymph node enlargement. Conclusion: Three percent of the patients with lymphadenopathy who were referred for suspected malignancy received a cancer diagnosis. This rate, which is too low for a reference center, suggested that the patients might be referred to the pediatric oncology outpatient clinic without a thorough evaluation in primary health care.