Objectives: The aim of this study was to evaluate the etiological factors for cervical lymphadenopathy in children and the role of ultrasonography (USG) in diagnosis.
Methods: A total of 200 children of significant cervical lymphadenopathy between 3 months to18 years were pro-spectively included in a tertiary referral hospital. All subjects were evaluated by history, examination, hemogram, chest X-ray, mantoux test, fine needle aspiration cytology (FNAC), acid-fast bacillus (AFB) staining, ultrasonography (USG) of lymph node. Open lymph node biopsy, bone marrow examination, serological tests were optional.
Results: A total of 84 subjects (42%) identified as benign reactive, 80 (40%) as tuberculosis, 20 (10%) chronic lym-phadenitis, 12 (6%) non-Hodgkin and 4 (2%) Hodgkin’s lymphoma by USG. However, on USG among 84 subjects of benign reactive lymphadenopathy, 60 (71.4%) were having features of benign reactive lymph node, remaining 24 (28.6%) have normal sonogram; out of 80 subjects of tuberculosis lymphadenitis 66 (82.5%) have features of tuber-culosis and rest14 (17.5%) have nonspecific ultrasound changes; among 16 subjects of lymphoma, 10 (62.5%) have features of malignancy, rest 6 (37.5%) have nonspecific changes in USG examination. Male to Female ratio was1.68:1. Cervical lymphadenopathy was most prevalent in 6 to 10 years age group.
Conclusion: Reactive lymphadenitis due to underlying acute bacterial or viral infection was the commonest cause of significant cervical lymphadenopathy in children and ultrasonography is a good noninvasive diagnostic modality, but requires other tests for definitive diagnosis.