Risk factors for malignancy in pediatric subacute/chronic focal craniocervical lymphadenopathy
AimsTo describe the factors associated with malignancy in otherwise healthy children with focal persistent isolated craniocervical lymphadenopathy at low risk for malignancy, in order to aid in decisions of nodal surgical excision.Material and methodsDemographic and clinical data were retrospectivel...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2024.1466116/full |
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| author | Yishai Haimi-Cohen Yishai Haimi-Cohen Yishai Haimi-Cohen Eyal Elron Eyal Elron Lital Oz-Alcalay Lama Hejly Roy Hod Roy Hod Liat Ashkenazi-Hoffnung Liat Ashkenazi-Hoffnung Liat Ashkenazi-Hoffnung |
| author_facet | Yishai Haimi-Cohen Yishai Haimi-Cohen Yishai Haimi-Cohen Eyal Elron Eyal Elron Lital Oz-Alcalay Lama Hejly Roy Hod Roy Hod Liat Ashkenazi-Hoffnung Liat Ashkenazi-Hoffnung Liat Ashkenazi-Hoffnung |
| author_sort | Yishai Haimi-Cohen |
| collection | DOAJ |
| description | AimsTo describe the factors associated with malignancy in otherwise healthy children with focal persistent isolated craniocervical lymphadenopathy at low risk for malignancy, in order to aid in decisions of nodal surgical excision.Material and methodsDemographic and clinical data were retrospectively obtained for children with subacute and chronic craniocervical lymphadenopathy, treated from January 2008 to December 2020 at a general pediatric ambulatory clinic of a tertiary center. Univariate and multivariate analyses of risk factors for malignancy were performed.ResultsOf the 450 children included, median age 4.2 years (interquartile age: 2.4–8.7), 25 (5.6%) were eventually diagnosed with a malignancy. In univariate analysis, factors associated with malignancy included older age, increased nodal size, location (supraclavicular and lateral cervical), systemic signs such as decreased appetite and weight loss, and abnormal imaging studies. Referral by an ear, nose, throat specialist vs. a family physician or a pediatrician was also associated with malignancy. Fever, night sweats, pruritus, hepatosplenomegaly and laboratory workup were not associated with malignancy. Twenty percent of the children older than 12.5 years and 12% of those with a lymph node diameter >31 mm were diagnosed with malignancy. Multivariate analysis showed associations with malignancy of older age and larger lymph nodes; the respective odds ratios were 1.649 (95%CI: 1.197–2.349, p = 0.004) for every 3 years and 2.080 (95%CI: 1.292–3.330, p = 0.002) for every one centimeter.ConclusionsOlder age and increased nodal size can help identify children with focal craniocervical lymphadenopathy who are at increased risk for malignancy and for whom surgical intervention should be strongly considered. |
| format | Article |
| id | doaj-art-66bc3a41c40a496bba166b970ea2a21a |
| institution | Kabale University |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pediatrics |
| spelling | doaj-art-66bc3a41c40a496bba166b970ea2a21a2025-01-30T06:22:10ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-01-011210.3389/fped.2024.14661161466116Risk factors for malignancy in pediatric subacute/chronic focal craniocervical lymphadenopathyYishai Haimi-Cohen0Yishai Haimi-Cohen1Yishai Haimi-Cohen2Eyal Elron3Eyal Elron4Lital Oz-Alcalay5Lama Hejly6Roy Hod7Roy Hod8Liat Ashkenazi-Hoffnung9Liat Ashkenazi-Hoffnung10Liat Ashkenazi-Hoffnung11Department for Day Hospitalization, Schneider Children’s Medical Center of Israel, Petah Tikva, IsraelInfectious Diseases Unit, Schneider Children’s Medical Center of Israel, Petah Tikva, IsraelFaculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, IsraelFaculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, IsraelDepartment of Neonatology, Schneider Children’s Medical Center of Israel, Petah Tikva, IsraelDepartment of Pediatrics A, Schneider Children’s Medical Center of Israel, Petah Tikva, IsraelDepartment for Day Hospitalization, Schneider Children’s Medical Center of Israel, Petah Tikva, IsraelFaculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, IsraelDepartment of Otorhinolaryngology, Schneider Children’s Medical Center of Israel, Petah Tikva, IsraelDepartment for Day Hospitalization, Schneider Children’s Medical Center of Israel, Petah Tikva, IsraelInfectious Diseases Unit, Schneider Children’s Medical Center of Israel, Petah Tikva, IsraelFaculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, IsraelAimsTo describe the factors associated with malignancy in otherwise healthy children with focal persistent isolated craniocervical lymphadenopathy at low risk for malignancy, in order to aid in decisions of nodal surgical excision.Material and methodsDemographic and clinical data were retrospectively obtained for children with subacute and chronic craniocervical lymphadenopathy, treated from January 2008 to December 2020 at a general pediatric ambulatory clinic of a tertiary center. Univariate and multivariate analyses of risk factors for malignancy were performed.ResultsOf the 450 children included, median age 4.2 years (interquartile age: 2.4–8.7), 25 (5.6%) were eventually diagnosed with a malignancy. In univariate analysis, factors associated with malignancy included older age, increased nodal size, location (supraclavicular and lateral cervical), systemic signs such as decreased appetite and weight loss, and abnormal imaging studies. Referral by an ear, nose, throat specialist vs. a family physician or a pediatrician was also associated with malignancy. Fever, night sweats, pruritus, hepatosplenomegaly and laboratory workup were not associated with malignancy. Twenty percent of the children older than 12.5 years and 12% of those with a lymph node diameter >31 mm were diagnosed with malignancy. Multivariate analysis showed associations with malignancy of older age and larger lymph nodes; the respective odds ratios were 1.649 (95%CI: 1.197–2.349, p = 0.004) for every 3 years and 2.080 (95%CI: 1.292–3.330, p = 0.002) for every one centimeter.ConclusionsOlder age and increased nodal size can help identify children with focal craniocervical lymphadenopathy who are at increased risk for malignancy and for whom surgical intervention should be strongly considered.https://www.frontiersin.org/articles/10.3389/fped.2024.1466116/fullbiopsybenignmalignancycervical lymphadenopathylymphoma |
| spellingShingle | Yishai Haimi-Cohen Yishai Haimi-Cohen Yishai Haimi-Cohen Eyal Elron Eyal Elron Lital Oz-Alcalay Lama Hejly Roy Hod Roy Hod Liat Ashkenazi-Hoffnung Liat Ashkenazi-Hoffnung Liat Ashkenazi-Hoffnung Risk factors for malignancy in pediatric subacute/chronic focal craniocervical lymphadenopathy Frontiers in Pediatrics biopsy benign malignancy cervical lymphadenopathy lymphoma |
| title | Risk factors for malignancy in pediatric subacute/chronic focal craniocervical lymphadenopathy |
| title_full | Risk factors for malignancy in pediatric subacute/chronic focal craniocervical lymphadenopathy |
| title_fullStr | Risk factors for malignancy in pediatric subacute/chronic focal craniocervical lymphadenopathy |
| title_full_unstemmed | Risk factors for malignancy in pediatric subacute/chronic focal craniocervical lymphadenopathy |
| title_short | Risk factors for malignancy in pediatric subacute/chronic focal craniocervical lymphadenopathy |
| title_sort | risk factors for malignancy in pediatric subacute chronic focal craniocervical lymphadenopathy |
| topic | biopsy benign malignancy cervical lymphadenopathy lymphoma |
| url | https://www.frontiersin.org/articles/10.3389/fped.2024.1466116/full |
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