Clinical profile and histopathologic diagnoses of childhood peripheral lymphadenopathy: An MMC experience

ABSTRACT

Peripheral lymphadenopathy is a common clinical problem wherein surgery is performed, especially, when malignancy cannot be eliminated as a differential diagnosis. In the Philippine setting, there is a paucity of data on the incidence of lymphadenopathy in children. Objectives: This descriptive study aims to describe the clinical profile and histopathologic diagnoses of peripheral lymphadenopathy requiring biopsy in children aged one-to-eighteen years seen at the Makati Medical Center (MMC) from 1998 to 2008. Methods: Patients' charts were reviewed and 22 patients were included in the study; 17 were male and 5 were female. All patients underwent excision biopsy, except for one who had fine needle aspiration biopsy. Results: The most common sites of peripheral lymphadenopathy were cervical (78%) and inguinal (14%). The most common histopathologic diagnoses were benign etiology (46%), tuberculous (TB) adenitis (32%), and malignancy (23%). Of the malignant cases, three were Hodgkin's lymphoma and two were non-Hodgkin's lymphoma. Clinical profile included the findings that patients with benign etiology were younger, presented more frequently with fever; and males were more commonly affected; whereas children with malignant etiology were older, had a shorter duration of lymphadenopathy, which were of a larger size, and with accompanying weight loss. Conclusion: The following occurred more often in patients with malignancy: children more than 12 years old, cervical location of lymph nodes, shorter duration of lymph node enlargement, the lack of response to initial antibiotic treatment, and the presence of certain signs and symptoms such as fever and weight loss. Excision biopsy was the predominant surgical procedure used despite extensive invasiveness and the requirement of general anesthesia.