Etiologies and Clinical Characteristics of Cervical Lymphadenopathy in Children

Hur, Tae Hyung; Choi, Yun Jung; Kim, Eugene; Lee, Keun Young; Yoon, Jong Seo; Kim, Hyun Hee; Kim, Jin Tack; Lee, Joon Sung

Abstract

PURPOSE
This study was performed to investigate clinical characteristics and the etiology of cervical lymphadenopathy in children.
METHODS
A clinical review of 240 cases of children under the age of 18 who were admitted with cervical lymphadenopathy from January 2002 to December 2007.
RESULTS
Cervical lymphadenopathy was diagnosed as follows:clinically diagnosed lymphadenitis (52.1%), abscess (15%), necrotizing lymphadenitis (7.9%), reactive hyperplasia (5.4 %), tuberculous lymphadenitis (4.2%), Kawasaki disease (2.9%) and malignancy (2.5%). Abscess was presented as an acute lesion (94.1%) with less than 2 weeks of fever (69.4 %) and tuberculous lymphadenitis was presented as a chronic lesion (62.5%) without fever (90 %). Malignant disease (100%) and necrotizing lymphadenitis (62.5%) were found in chronic lesion of older children with systemic symptoms (40% and 37.5%, respectively). Leukopenia (57.9%) with various duration of fever occured in case of necrotizing lymphadenitis.
CONCLUSION
Clinically diagnosed lymphadenitis (52.1%), abscess (15%), necrotizing lymphadenitis (7.9%), reactive hyperplasia (5.4%), tuberculous lymphadenitis (4.2%), Kawasaki disease (2.9%) and malignancy (2.5%) were found in cervical lymphadenopathy. Although cervical lymphadenopathy was commonly caused by a benign infectious process, a more serious disease was not rare, which may have different clinical characteristics including age, duration of fever and disease, previous or accompanying symptoms, or white cell counts. Meticulous combination of clinical characteristics, history, physical examination and workup as well as follow-up may be the most important for the proper approach on cervical lymphadenopathy in children.