Predictors of malignancy in childhood peripheral lymphadenopathy.
OBJECTIVE
The aim of this study was to identify factors associated with malignant etiologies of childhood peripheral lymphadenopathy and to construct a model that may be used to assess the risk of malignancy.


METHODS
The medical records of 60 consecutive patients 18 years old or less who underwent peripheral lymph node biopsies were reviewed.


RESULTS
Increasing node size, number of sites of adenopathy, and age were associated with an increasing risk of malignancy (P < .05 for all variables). Graphs useful for risk determination were constructed based on these variables. Additional factors associated with malignancy included the presence of supraclavicular adenopathy (P < .01), an abnormal chest x-ray (P < .01), and fixed nodes (P < .01). Variables that were not statistically different between patients with benign and malignant adenopathy included the duration of adenopathy (P = .43), the presence of fever (P = .36), cough (P = .14), splenomegaly (P = .93), skin involvement (P = .39), tenderness (P = .49), and bilateral adenopathy (P = .39). Fluctuance was associated with benign adenopathy (P < .04).


CONCLUSIONS
The risk of malignancy increased with increasing size and number of sites of adenopathy and age. Other significant predictors of malignancy included supraclavicular location, an abnormal chest x-ray, and fixed nodes. These data may be used to supplement clinical judgment to predict the risk of malignancy.
Soldes
O S
OS
Department of Surgery, University of Michigan, C.S. Mott Children's Hospital, Ann Arbor 48109-0245, USA.
Younger
J G
JG
Hirschl
R B
RB
D002648:Child; D005260:Female; D006801:Humans; D016015:Logistic Models; D008206:Lymphatic Diseases / Q000209:etiology*; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors