Korean J Pediatr Gastroenterol Nutr.  2009 Mar;12(1):1-9.

The Clinical and Histopathologic Findings of Lymphonodular Hyperplasia of the Colon in Infancy and Childhood

• Nam YN
• Lee SH
• Chung DH
• Sim SY
• Eun BW
• Choi DY
• Sun YH
• Cho KH
• Ryoo E
• Son DW
• Jeon IS
• Tchah H

Abstract

PURPOSE: Lymphonodular hyperplasia of the colon (LNHC) is a rare finding in children and its significance as a pathologic finding is unclear. The aim of this study was to investigate the clinical significance of LNHC by analyzing clinical and histopathologic findings in children with LNHC.
METHODS
We analyzed data from 38 patients who were confirmed to have LNHC by colonoscopy. We checked age, birth history, past history, family history, and clinical symptoms. A hematologic exam, stool exam, and image studies were performed and biopsy specimens were examined by a pathologist. All patients were asked to have short- and long-term follow-up.
RESULTS
The mean age of the patients was 12.5+/-14.4 months. All patients presented with complaints of bloody stool. They appeared healthy and the hematologic findings were within a normal range, with the exception of one case. There was no other identified source of bleeding. On histologic exam, 36 patients (94.7%) had lymphoid follicles and 34 patients (84.5%) fulfilled the criteria of allergic colitis. Regardless of diet modification and presence of residual symptom, there was no recurrence of bloody stool through long-term follow-up in all patients.
CONCLUSION
LNHC is more common in infants who are affected by allergic colitis, but it can appear even after infancy. LNHC should be regarded as the etiology when there are any other causes of rectal bleeding, especially in healthy children. We suggest that LNHC has a benign course regardless of diet modification and it might not require excessive concerns.

Keyword

Lymphonodular hyperplasia; Colon; Children; Rectal bleeding; Food protein-induced proctocolitis

MeSH Terms

Biopsy
Child
Colitis
Colon
Colonoscopy
Follow-Up Studies
Food Habits
Hemorrhage
Humans
Hyperplasia
Infant
Lactosylceramides
Recurrence
Reference Values
Reproductive History
Lactosylceramides