Management of chronic cervical lymphadenopathy in children

BACKGROUND: It is important how to evaluate chronic cervical lymphadenopathies and when to perform excisional biopsy in children. We tried to analyze the usefulness of clinical and ultrasonographic findings in order to differentiate malign lymphadenopathies from benign ones. METHODS: This prospective study included 100 children who had cervical lymphadenopathies, larger than 1. 5 cm for 4 weeks duration at least. Children were between 2 and 14 years old, the mean age was 6.88 +/- 3.38 years. They were examined by clinical symptoms and ultrasonographic appearances. Persistent lymphadenopathies were evaluated by excisional biopsy. RESULTS: Cervical lymhadenopathies of 80 children with well clinical symptoms decreased and resolved within 10 weeks durations. Their ultrasonographic findings revealed regular margins, ovoid shapes and getting smaller than 1. 5 cm. The remaining 20 children persisting longer than 10 weeks at the same size, with worrisome clinical symptoms and susceptible ultrasonographic findings (round shapes, irregular margins) underwent excisional biopsy. According to the biopsy results, five had tubercular lymphadenopathies, three had Hodgkin'slenfoma, two had acute lymphoblastic leukemia. CONCLUSIONS: Chronic cervical lymphadenopathies can persist up to 10 weeks, althoughthey are reactive and benign.