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December 1994

Fine Needle Aspiration in the Evaluation of Children With Lymphadenopathy

Author Affiliations

From the Departments of Pediatrics (Drs Buchino and Jones) and Pathology (Dr Buchino), University of Louisville and Kosair Children's Hospital, Louisville, Ky.

Arch Pediatr Adolesc Med. 1994;148(12):1327-1330. doi:10.1001/archpedi.1994.02170120089017

Objective:  To evaluate fine needle aspiration of enlarged lymph nodes in children.

Design:  Retrospective study of children who were referred for fine needle aspiration of a palpable lymph node that was of concern to their clinicians.

Setting:  Large, urban, tertiary care pediatric hospital.

Subjects:  One hundred nineteen patients (123 cases) aged 10 months through 21 years during the 30-month period from January 1990 to June 1992.

Results:  Aspirated material in 13 cases (10.6%) was deemed inadequate for cytologic diagnosis. In the remaining 110 cases, five aspirates revealed malignancy: two patients had Hodgkin's disease, one had non-Hodgkin's lymphoma, one had a leukemic infiltrate, and one had rhabdomyosarcoma. The findings in two cases were suspicious for malignancy, but the lymph nodes were found to be benign on excisional biopsy. No false-negative findings for malignancy were detected. The conditions of patients in the remaining 103 cases were diagnosed as a benign process, most commonly reactive lymphadenitis. Of 57 aspirates cultured, eight (14%) were positive for a microorganism. No significant complications were encountered in any of the 123 cases.

Conclusion:  Fine needle aspiration of enlarged lymph nodes in children is a safe, reliable (accuracy, 98%) procedure that often obviates the need for an excisional biopsy.(Arch Pediatr Adolesc Med. 1994;148:1327-1330)