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Objectives: In our study, we aimed to investigate the clinical characteristics and cancer frequency in patients referred to our pediatric oncology outpatient clinic for lymphadenopathy. Methods: The charts of patients admitted to our pediatric oncology outpatient clinics for lymphadenopathy between January 2014, and December 2016 were retrospectively reviewed in this study. Age, gender, duration of complaints, previous therapies, systemic signs and symptoms, lymph node characteristics and laboratory findings were recorded. The frequency of malignancy was calculated. Results: One hundred thirty-four patients (34 girls) with a median age of six years (range four months-17 years) were included in our study. The majority of the patients (98%) had localized lymphadenopathy and the head and neck region was the most common site of involvement (87%). The median long-axis diameter of lymph nodes ranged between 0.5 cm and 5 cm (median 2 cm) by physical examination. Twenty-one patients (15.6%) had lymph node biopsy. Four patients had ruptured epidermal cyst, lymphangioma, pilomatricoma and ectopic thymus. Of the other biopsies, nine patients were diagnosed with reactive LAP, four with lymphadenitis, and four with Hodgkin’s disease. The lymphoma patients had lymph node size greater than 2.5 cm and the duration of lymphadenopathy was longer than four weeks. Three out of four patients had systemic clinical findings accompanying lymph node enlargement. Conclusion: Three percent of the patients with lymphadenopathy who were referred for suspected malignancy received a cancer diagnosis. This rate, which is too low for a reference center, suggested that the patients might be referred to the pediatric oncology outpatient clinic without a thorough evaluation in primary health care.
Purpose: Lymphadenopathy (LAP) is a common clinical finding in childhood. It is mostly reactive and well-published and rarely includes childhood cancer in its ethology. The frequency of cancer among patients monitored due to LAP varies according to the centers. In the first stage, very few patients are diagnosed with cancer, while the frequency increases in reference centers such as oncological clinics. The transfer of patients without sufficient assessment in terms of cancer risk reduces the rate of cancer in the reference centers. Our study aimed at investigating the clinical, laboratory characteristics and the frequency of cancer of patients sent to the child oncology clinic due to LAP. Patients and Method: The records of LAP patients who apply between January 2014 and December 2016 in our children's oncology clinics have been reviewed backward. Age, gender, approximation time, treatment, systemic signs and findings, lymphatic nodus characteristics, laboratory results were recorded; cancer frequency was calculated. The findings: The age varied from 4 months to 17 years (the average age of 6 years), 34 girls and 100 men formed a 134 patient study group. 98% of the lymphatic nodes were regional, 87% were in the head-to-head area, and in physical examination their sizes varied from 0.5 to 5 cm (2 cm in average). 21 of the cases (15.6%) were biopsied. In the pathological examination, four patients identified non-LAP causes (perfore epidermal cyst, lymphangioma, pilomatricoma, ectopic timus). Nine of the other biopsis were diagnosed with reactive LAP, four with lymphadenitis, and four with Hodgkin lymphoma. In all patients diagnosed with cancer, the size of the LAP is more than 2.5 cm and the period after the detection of the LAP lasted more than four weeks. Three of these incidents were accompanied by systemic findings to the LAP. Result: Only 3 percent of LAP patients sent to the child oncology clinic with cancer suspected have been diagnosed with cancer. This rate, which is very low for the reference center, suggested that patients that can be monitored in the first stage health centers were directed to the oncology clinic without sufficient assessment and risk factors without monitoring. (SETB-2018-05-075)
Field : Sağlık Bilimleri
Journal Type : Ulusal
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