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>Journals >Cirugía y Cirujanos >Year 2009, Issue 6


Sotelo-Cruz N, Cordero-Olivares A, López-Cervantes G, Romero-Esquer JA
Utilidad de segunda biopsia de ganglio linfático con informe previo de hiperplasia linfoide reactiva en niños
Cir Cir 2009; 77 (6)

Language: Español
References: 19
Page: 431-435
PDF: 80.80 Kb.

[Full text - PDF]

ABSTRACT

Background: Physicians in daily practice frequently attend children who present an increase in lymph node size. Care should be undertaken to determine which children require biopsy. Our objective was to analyze the usefulness of the peripheral lymph node biopsy in pediatric diagnosis. Methods: We reviewed histological reports of 364 lymph node biopsies. Variables were age, sex, lymphadenopathy evolution time, laboratory and imaging studies, and histopathology diagnoses. Parametric and nonparametric tests were used. Results: There were 211 males (57.9 %) and 153 females (42.0 %), the 1- to 6-year age group included 50.8% of cases. Average disease-evolution time was 5 months, and the predominant anatomic site was the cervical region. Histological report was reactive lymphoid hyperplasia (RLH) in 46.9%, followed by neoplasms in (24%), and granulomas (14.5%). Other diagnoses and normal lymph nodes represented 14.6 %. Of the 95 patients with high-risk lymphadenopathy, 29 cases had oncological diagnoses. Spearman coefficient was R2 = 0.3485. To obtain a specific diagnosis indicates the probability of disease in lymph nodes of risk areas. However, the majority of the diagnoses were obtained from lymph nodes in different areas (Fisher test, p ‹0.001). In 25 children with RLH, the binominal probability of diagnosis in the second biopsy was p = 0.0493. There was a ›75% chance for detecting disease. Conclusions: Peripheral lymph nodes within high-risk regions indicate probability relationship for determining disease. In persistent lymphadenopathy with an initial report of RLH, it is important to consider a second biopsy with high probability to obtain a specific diagnosis.


Key words: Lymph node biopsy in children, reactive lymphoid hyperplasia, lymphoma, tuberculosis, coccidioidomycosis.


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>Journals >Cirugía y Cirujanos >Year 2009, Issue 6
 

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