The ongoing problem with peripheral lymphadenopathies: which ones are malignant?
OBJECTIVE
Peripheral lymphadenopathy is frequently encountered in children, but it is difficult to determine the etiology. Our aim in this study was to evaluate the risk of malignancy in childhood peripheral lymphadenopathy, determine the factors accompanying a malignant etiology and find out which additional findings strongly indicate malignancy.


METHODS
Patients from whom a peripheral lymphadenopathy biopsy had been obtained between January 2005 and December 2007 were retrospectively reviewed. The patients were divided into two groups as malignant and benign.


RESULTS
There were 32 patients in the malignant group and 52 in the benign group. The mean age was higher (P < 0.001), lymphadenopathy duration shorter (P = 0.007) and lymphadenopathy size larger (P = 0.019) in the malignant group. The incidence of malignancy was higher in supraclavicular and axillary lymphadenopathies. Hodgkin's disease was the most common disease in the malignant group, while it was reactive lymphoid hyperplasia in the benign group. The biopsy result was malignant in 58.3% of abdominal and 60% of mediastinal lymphadenopathy cases. The best indicator for malignancy was a hypoactive spleen nodule.


CONCLUSIONS
Increased patient age, supraclavicular lymphadenopathy localization, presence of abdominal or mediastinal lymphadenopathy and especially a hypoactive spleen nodule increase the risk of malignancy.
Karaman
Ayşe
A
Department of Pediatric Surgery, Dr. Sami Ulus Children's Hospital, Ankara, Turkey. ayseuk@gmail.com
Karaman
Ibrahim
I
Cavuşoğlu
Yusuf Hakan
YH
Erdoğan
Derya
D
D000005:Abdomen / Q000473:pathology; D000293:Adolescent; D000367:Age Factors; D001706:Biopsy; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008206:Lymphatic Diseases / Q000209:etiology* / Q000473:pathology; D008477:Mediastinal Diseases / Q000473:pathology; D009369:Neoplasms / Q000150:complications* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors