Turkish Journal of Pathology

Türk Patoloji Dergisi

Turkish Journal of Pathology

Turkish Journal of Pathology

2021, Vol 37, Num, 3     (Pages: 219-225)

Peripheral Lymphadenopathy in Children: Cytomorphological Spectrum and Interesting Diagnoses

Arti KHATRI 1, Nidhi MAHAJAN 1, Sonali MALIK 2, Kanika RASTOGI 1, Parveen KUMAR 3, Diganta SAIKIA 4

1 Department of Pathology, Chacha Nehru Bal Chikitsalaya, DELHI, INDIA
2 Medical Student, Gajra Raja Medical College, GWALIOR, INDIA
3 Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, DELHI, INDIA
4 Department of Pediatric Medicine, Chacha Nehru Bal Chikitsalaya, DELHI, INDIA

DOI: 10.5146/tjpath.2021.01537
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Objective: Peripheral lymphadenopathy is a common complaint in the pediatric outpatient department. Fine needle aspiration cytology is the first investigation of choice with a high sensitivity for diagnosis but cytology may be challenging in some cases. The study was planned to study the cytomorphological spectrum and discuss a few interesting cases.

Material and Method: 1890 paediatric subjects’ up to 12 years of age with significant peripheral lymph node enlargement and an adequate cytology specimen were included in the study. Inadequate aspirates were excluded.

Results: The majority of children presented within 4-8 years of age with a male to female ratio of 1.7:1. The anterior cervical group was most commonly affected, followed by the posterior cervical, axillary and inguinal. Reactive lymphadenitis constituted the majority of the diagnoses, followed by Tuberculosis, acute suppurative, BCG-induced lymphadenitis, Kimura disease, Rosai-Dorfmann disease and Kikuchi-Fujimoto disease. Lymphomas and metastatic malignancies were less common, and mainly consisted of Hodgkin lymphoma, non-Hodgkin lymphoma, anaplastic large cell lymphoma, and Langerhans cell histiocytosis. Cytomorphological features of a few challenging and interesting cases have been discussed.

Conclusion: Non neoplastic causes of lymphadenopathy predominate in the pediatric age group. A definitive diagnosis rests upon a complete clinical, radiological, microbiological, and cyto-histopathological correlation with the use of ancillary techniques wherever necessary.

Keywords : Lymphadenopathy, Cytology, Child, Lymphomas, Mycobacterium