When Is Lymph Node Biopsy Indicated in Children with Enlarged Peripheral Nodes?
1 Departments of Surgery and Pediatrics, Children's Hospital, Mt Carmel East Hospital, and Riverside Methodist Hospital, Columbus, Ohio
To better define the indications for diagnostic biopsy, 239 children who underwent peripheral lymph node biopsy were reviewed. The duration of the lymphadenopathy by history, the consistency of the lymph nodes, and the presence of more than one site of palpable adenopathy were not specific in differentiating serious diseases involving lymph nodes from reactive hyperplasia. The differential diagnosis of specific causes for lymph node enlargement is approached based on the child's age, the location of the adenopathy, and the presence or absence of lymph node fixation and tenderness. Most children with supraclavicular adenopathy, children sick with fever of one week's duration or with weight loss for which a specific diagnosis is not readily made, and some children with fixation of the lymph node to the overlying skin should undergo early biopsy. Excluding the above findings, when a specific diagnosis is not apparent, serial measurements with a ruler over several weeks appears to be the most reasonable method, at the present time, of discriminating hyperplastic lymph nodes from nodes that are involved by a progressive disease process.
Submitted on April 21, 1981Accepted on July 8, 1981
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  A. M. Friedmann Evaluation and Management of Lymphadenopathy in Children Pediatr. Rev., February 1, 2008; 29(2): 53 - 60. [Full Text] [PDF]
|
|
|
|
 |
|
 N. Yaris, M. Cakir, E. Sozen, and U. Cobanoglu Analysis of Children with Peripheral Lymphadenopathy Clinical Pediatrics, July 1, 2006; 45(6): 544 - 549. [Abstract] [PDF]
|
|
|
|
 |
|
 H.-C. Lin, C.-Y. Su, and S.-C. Huang Kikuchi's Disease in Asian Children Pediatrics, January 1, 2005; 115(1): e92 - e96. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. S. Nield and D. Kamat Lymphadenopathy in Children: When and How to Evaluate Clinical Pediatrics, January 1, 2004; 43(1): 25 - 33. [PDF]
|
|
|
|
|
|
T. R. Peters and K. M. Edwards Cervical Lymphadenopathy and Adenitis Pediatr. Rev., December 1, 2000; 21(12): 399 - 405. [Full Text]
|
|
|
|
 |
|
 H. A. Carithers and A. M. Margileth Cat-Scratch Disease: Acute Encephalopathy and Other Neurologic Manifestations Arch Pediatr Adolesc Med, January 1, 1991; 145(1): 98 - 101. [Abstract] [PDF]
|
|
|
|
 |
|
 G. B Slap, J. L. Connor, R. S. Wigton, and J. S. Schwartz Validation of a Model to Identify Young Patients for Lymph Node Biopsy JAMA, May 23, 1986; 255(20): 2768 - 2773. [Abstract] [PDF]
|
|
|
|
|
|
A. M. Margileth, R. Chandra, and R. P. Altman Chronic Lymphadenopathy due to Mycobacterial Infection: Clinical Features, Diagnosis, Histopathology, and Management Arch Pediatr Adolesc Med, October 1, 1984; 138(10): 917 - 922. [Abstract] [PDF]
|
|
|
|
|
|
G. B. Slap, J. S. J. Brooks, and J. S. Schwartz When to Perform Biopsies of Enlarged Peripheral Lymph Nodes in Young Patients JAMA, September 14, 1984; 252(10): 1321 - 1326. [Abstract] [PDF]
|
|
|
|
|
|
A. M. MARGILETH Cat-scratch Disease Update Arch Pediatr Adolesc Med, August 1, 1984; 138(8): 711 - 713. [Abstract] [PDF]
|
|
|
|
|
|
V. C. Strasburger Why Adolescent Medicine?: Four Illustrative Cases Clinical Pediatrics, January 1, 1984; 23(1): 12 - 16. [Abstract] [PDF]
|
|
|
|
|
|
L. W. Herzog Prevalence of Lymphadenopathy of the Head and Neck in Infants and Children Clinical Pediatrics, July 1, 1983; 22(7): 485 - 487. [Abstract] [PDF]
|
|
