title: Cervical lymphadenopathies in children: A prospective clinical cohort study.
abstract: OBJECTIVE
  Cervical lymphadenopathy (LAP) is a common sign and may raise fears about serious illnesses. The aim of our study was to evaluate the patients with cervical LAPs in a general pediatrics clinic setting, and to evaluate follow-up results for potential causes and risk factors for malignancies.
  
  
  METHODS
  Two hundred-eighteen patients aged between 79.4±46.7 months with LAP were enrolled in this prospective cohort study. The patients were examined in terms of demographics, clinical, radiologic and serologic aspects like Epstein-Barr virus (EBV), cytomegalovirus (CMV), parvovirus B19. A lymph node biopsy was performed in selected patients. The patients were followed-up for 8 weeks and risk factors for malignancy were evaluated.
  
  
  RESULTS
  Seventy patients (41.3%) had specific etiology and 6 (2.7%) had malignant causes. The causes were as follows: 27% (n=59) infections; 2.7% (n=6) malignancies; 11.4% (n=25) other causes. EBV was responsible for 27% of infectious causes. The other common infectious etiologies were CMV 4.3%, parvovirus B-19 2.9%, and group-A beta-hemolytic streptococcus (GAS) 10.8%. Four of the six malignancies were lymphomas. Predictive factors for malignancy were having LAP larger than 30mm, rubbery lymph node, high serum CRP and LDH values, no hilum in ultrasonography, and enlargement of lymph node in follow-up. High uric acid levels and leucopenia were also common in the malignancy group.
  
  
  CONCLUSIONS
  Etiology of cervical LAPs was diagnosed in 41.3% patients. Infectious causes were the most common cause with 27%. Malignancy was diagnosed in 2.7% and lymphoma was the most common malignancy.
authors: Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Istanbul, Turkey. Electronic address: serdar_bozlak@hotmail.com.
authors: Serdar
authors: S
authors: Bozlak
authors: Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Ambulatory Pediatrics, Istanbul, Turkey. Electronic address: drmavarkal@yahoo.com.
authors: Muhammet Ali
authors: MA
authors: Varkal
authors: Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Ambulatory Pediatrics, Istanbul, Turkey. Electronic address: drismail810@yahoo.com.
authors: Ismail
authors: I
authors: Yildiz
authors: Bulent Ecevit University, Faculty of Medicine, Department of Forensic Medicine, Zonguldak, Turkey. Electronic address: sadik_toprak@yahoo.com.
authors: Sadik
authors: S
authors: Toprak
authors: Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology & Oncology, Istanbul, Turkey. Electronic address: drkaramans@yahoo.com.
authors: Serap
authors: S
authors: Karaman
authors: Istanbul University, Istanbul Faculty of Medicine, Department of Radiology, Division of Pediatric Radiology, Istanbul, Turkey. Electronic address: erolob@gmail.com.
authors: Oguz Bülent
authors: OB
authors: Erol
authors: Istanbul University, Istanbul Faculty of Medicine, Department of Radiology, Division of Pediatric Radiology, Istanbul, Turkey. Electronic address: ensaryekeler@gmail.com.
authors: Ensar
authors: E
authors: Yekeler
authors: Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology & Oncology, Istanbul, Turkey. Electronic address: aysegulu@hotmail.com.
authors: Ayşegul
authors: A
authors: Unuvar
authors: Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Ambulatory Pediatrics, Istanbul, Turkey. Electronic address: draysekilic@gmail.com.
authors: Ayse
authors: A
authors: Kilic
authors: Istanbul University, Institute of Child Health, Istanbul, Turkey. Electronic address: faoguz2000@yahoo.com.
authors: Fatma
authors: F
authors: Oguz
authors: Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Ambulatory Pediatrics, Istanbul, Turkey. Electronic address: eminu@istanbul.edu.tr.
authors: Emin
authors: E
authors: Unuvar
mesh_terms: D000293:Adolescent; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007970:Leukopenia / Q000453:epidemiology; D008198:Lymph Nodes / Q000473:pathology; D008206:Lymphatic Diseases / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D009333:Neck; D010322:Parvoviridae Infections / Q000453:epidemiology; D011446:Prospective Studies; D013290:Streptococcal Infections / Q000453:epidemiology; D013297:Streptococcus pyogenes; D014421:Turkey / Q000453:epidemiology; D014527:Uric Acid / Q000097:blood
chemical_list: D014527:Uric Acid; D002097:C-Reactive Protein; D007770:L-Lactate Dehydrogenase
keywords: Child; Lymphadenopathy; Malignancy