title: Chronic cervical lymphadenopathy in children: Role of ultrasonography.
abstract: OBJECTIVE
  To assess the usefulness of ultrasonography in the differentiation of causes of chronic cervical lymphadenopathy in children.
  
  
  METHODS
  Children with palpable cervical lymph nodes were included. An ultrasonographic examination was performed to delineate multiple lymph nodes, irregular margins, tendency towards fusion, internal echos, the presence of strong echoes and echogenic thin layer.
  
  
  RESULTS
  The total number of patients was 120. Echogenic thin layer and strong internal echoes were specific for tuberculosis. Long axis to short axis (L/S) ratio was more than 2 in most of the tubercular nodes (85.71%). Hilus was present in 50 (73.53%) tubercular lymphadenitis, 12 (40%) lymphoma and 10 (62.5%) cases with metastatic lymph nodes. Hypoechoic center was present in 60 (88.24%) tubercular lymphadenitis cases followed by 62.5% metastatic and 60% malignant lymphoma cases.
  
  
  CONCLUSIONS
  Ultrasonography is a non-invasive tool for lymph nodal evaluation in children. It may be used to differentiate cervical lymphadenopathy with different etiologies in children. When correlated clinically, it may avoid biopsy in a patient.
authors.affiliation: Department of Pediatric Surgery, CSM Medical University (Erstwhile King George's Medical University), Lucknow, India.
authors.forename: Anand
authors.initials: A
authors.lastname: Pandey
authors.forename: Shiv N
authors.initials: SN
authors.lastname: Kureel
authors.forename: Jigyasa
authors.initials: J
authors.lastname: Pandey
authors.forename: Ashish
authors.initials: A
authors.lastname: Wakhlu
authors.forename: Jiledar
authors.initials: J
authors.lastname: Rawat
authors.forename: Tej Bali
authors.initials: TB
authors.lastname: Singh