versão On-line ISSN 1683-9803
GENES DE LOVERA, L; RIVAROLA, C e MATTIO, I. Adenomegaly in children. Diagnostic approach in the hemato-oncology clinic of a Reference Hospital. Pediatr. (Asunción) [online]. 2006, vol.33, n.1, pp.15-19. ISSN 1683-9803.
Introduction: Adenopathy is one of the most frequent chief complaints in pediatric hematology. Although most cases are due to benign, transitory, self-limited processes, sometimes it is the first manifestation of a more severe disease, such as malignancy. Objectives: To determine the clinical characteristics and the diagnostic methods used in patients presenting with adenopathy at the Hemato-oncology Department of the Pediatric Service of the CMI-Hospital de Clínicas, from January 2000 to July 2005. Materials and Methods: This is a descriptive, retrospective, transverse cut study based on clinical records from January 2000 to July 2005. Results: A total of 65 patients presenting with adenopathy were analyzed. Age range was from 1 to 16, with a predominance of children under the age of 5 (41.5%) and a majority of males (68%). Average time since onset of symptoms was 207 days. Most, 81% (53/65) patients presented with localized adenomegaly, of which 66% were in the lateral cervical area. Only 18.5% (12/65) had generalized adenomegaly. The association with splenomegaly was seen in 18.5% (12/65), hepatomegaly in 17% (11/65) and systemic symptoms in 31% (20/65). Chest films were done in 91% (59/65), with a finding of widened mediastinum in 34% (20/59). Abdominal ultrasound was done in 55% (36/65), with a finding of hepatomegaly in 14% (5/36), lymph adenopathy in 5% (2/36). Abdominal CT was done in 49% (32/65), and showed retroperitoneal and para-aortic adenopathy in 22% (7/32). Chest CT was done in 49%, and showed mediastinal adenopathy and pulmonary nodules in 37.5% (12/32). Lymph node biopsy was indicated in 66% of cases, and bone marrow aspirate in 48%. Malignant diseases were slightly more frequent that benign diseases (infectious adenitis in 37%, non-specific reactive hyperplasia in 5%(3/65). Hodgkin's lymphoma was found in 48% of cases (31/65). Conclusions: Children with adenopathy must be managed according to a strictly ordered protocol, designed to deliver the best care for each case, with timely diagnosis and adequate treatment.
Palavras-chave : Adenomegaly; diagnosis; children.