ÇOCUKLUK ÇAĞI PERİFERİK LENFADENOPATİLERİ

Lenfadenopatilerin tanımlanması ve lenfadenopatiye yaklaşım pediatri pratiğinde sık tartışılan konulardanbirisidir. Hasta veya sağlıklı çocuklarda lenf bezlerinin değerlendirilmesi, genel fizik incelemenin önemli birparçasıdır. Lenfadenopati, lenf bezlerinin boyut, sayı veya kıvam özelliklerinde anormallik göstermesidir vediğer bulgu ve semptomların bir parçası olabileceği gibi, tek bulgu veya ana yakınma olabilir. Ayırıcı tanıdabirçok hastalık yer alır ve doğru yaklaşımda zorluk çekilebilir. Genellikle kendini sınırlayıcı, beniyn bir durumolabilmesine karşın altta yatan ciddi sistemik bir hastalığın veya maliynitenin ipucu olabilir. Bu makalenin amacılenfadenopati tanımı, bölgesel ve yaygın lenfadenopatinin ayırıcı tanısı, lenfadenopatili hastanındeğerlendirilmesinde sistematik yaklaşım, acil biyopsi yapılması gereken durumlar gibi önemli noktalarıngözden geçirilmesidir

Anahtar Kelimeler:

Çocuk, lenfadenopati, lenfadenit

Peripheral Lymphadenopathy in Childhood

The assessment of lymphadenopathy in children is a common diagnostic problemin pediatrics. Examining the lymph nodes is an important aspect of the general physical examination of both well and ill children and adolescents. The term “lymphadenopathy” refers to lymph nodes that are abnormal in size, number, or consistency. The majority of children with lymphadenopathy will have a benign, self-limited process. Conversely, the presence of lymphadenopathy can be a clue to a serious underlying systemic disease or malignancy, and the differential diagnosis of lymphadenopathy can be broad. The aim of this article is define lymphadenopathy, discuss the differential diagnosis of localized and generalized lymphadenopathy develop a systematic approach to the evaluation and management of lymphadenopathy, recognize worrisome features of lymphadenopathythat shouldprompt a referral fora biopsy.

Keywords:

Children, lymphadenopathy, lymphadenithis,

PDF

___

1. Friedman AM. Evaluation and management of lymphadenopathy in children. Pediatr Rev 2008;29:53- 60.
2. Neville KA. Clinical assesment and differential diagnosis of the child with suspected cancer. In: Pizzo P, Poplack D, Editors. Principles and practices of pediatric oncology. 5rd ed. Philadelphia, PA: LippincottWilliamsWilkins;2006:150-2.
3. Olgun N.Çocukluk çağı lenf bezleri.İrken G, Özkan H, Aydın A, editörler. Pediatri Kliniğe Giriş. 1. baskı, DEU Rektörlük Matbaası,İzmir, 2001:71-93.
4. Bamji M, Stone RK, Kaul A, Usmani G, Schachter FF, Wasserman E. Palpable lymph nodes in healthy newborns and infants. Pediatrics 1986;78:573.
5. Herzog LW. Prevalence of lymphadenopathy of the head and neck in infants and children. Clin Pediatr 1983;22:485-7.
6. Lake AM, Oski FA. Peripheral lymphadenopathy in childhood.Ten-year experience with excisional biopsy Am J DisChild 1978;132:357-9.
7. Soldes OS, Younger JG, Hirschl RB. Predictors of malignancy in childhood peripheral lymphadenopathy. J Pediatr Surg 1999; 34: 1447-52.
8. Pangalis GA, Vassilakopoulos TP, Boussiotis VA, Fessas P. Clinical approach to lymphadenopathy. Semin Oncol 1993; 20: 570-82.
9. Karadeniz C, OguzA, Ezer U, Oztürk G, DursunA. The etiology of peripheral lymphadenopathy in children. Pediatr Hematol Oncol 1999; 16: 525-31.
10. Kumral A, Olgun N, Uysal KM, Corapcioğlu F, Oren H, Sarialioğlu F. Assessment of peripheral lymphadenopathies: experience at a pediatric hematology-oncology department in Turkey. Pediatr Hematol Oncol 2002; 19: 211-8.
11. Oguz A, Karadeniz C, Temel EA, Citak EC, Okur FV. Evaluation of peripheral lymphadenopathy in children. Pediatr Hematol Oncol 2006; 23: 549-61.
12. F i j t e n G H , B l i j h a m G H . U n e x p l a i n e d lymphadenopathy in family practice. An evaluation of the probability of malignant causes and the effectiveness of physicians' workup. J Fam Pract 1988;27:373-6.
13. Knight PJ, Mulne AF, Vassy LE. When is lymph node biopsy indicated in children with enlarged peripheral nodes? Pediatrics 1982;69:391.
14. Twist CJ, Link MP.Assessment of lymphadenopathy in children. PediatrClin NorthAm 2002;49:1009-25.
15. Ancliff P, Hann I. Lymphadenopathy, 1. generalized lymphadenopathy. In: Sills RH, editor. Practical algorithims in pediatric hematology and oncology, Karger Publisher, 2003:46.