Diagnostyka różnicowa powiększonych węzłów chłonnych u dzieci

*Katarzyna Pawelec¹,Joanna Wiechecka², Dariusz Boruczkowski³

Summary
Introduction. Enlarged lymph nodes are one of the most frequent clinical problems in children. The benign diseases are the cause of it in most cases. However, the lymphadenopathies can be also the first symptom of the neoplasm.
The aim of the study was the retrospective analyse of causes and the differential diagnostics of the lymphadenopathy in children admitted to the Department of Pediatric, Hematology and Oncology Medical University of Warsaw.
Material and methods. 174 children were examined between January 2010 and December 2012. All information from the medical histories, physical examination, laboratory and radiological findings were analyzed in our study. Moreover, the data from the selected cases of the histopathological diagnosis were included to the study. Received information was analyzed statistically using the program SAS 9.2.
Results. The cause of the lymphadenopathy was benign disease in 90.8% of the cases. The main causes were: idiopathic, postinfectious and reactive. In 16 (9.2%) patients the neoplasm was diagnosed. Hodgkin disease was detected in 9 (5.2%) children, acute leukemia was detected in 2 (1.1%) children and non-Hodgkin lymphoma in 3 (1.1%) children.
Conclusion. The results of the analyse showed that lymphadenopathy in children is not the cause of the neoplasm in most cases. The most helpful in the differential diagnostics are the radiological findings (chest X-ray, abdominal USG), then the laboratory findings of the indicators of inflammation and complete blood count with peripheral blood smear. In the cases of the generalized lymphadenopathy and hepathosplenomegaly, the neoplasm should be always excluded. In these cases the biopsy of the lymph node and the bone marrow smear are indispensable.

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