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Paediatric Pathology Online

Pathology of Cervical Lymphadenopathy

Dr Sampurna Roy MD   




Cervical lymphadenopathy is common and most excised nodes show non-specific reactive hyperplasia.

Less frequent are lymphomas, the commonest malignant neoplasms of the head and neck.

Florid follicular hyperplasia may cause diagnostic concern, however follicular lymphoma is very rare in childhood.

Proliferation of atypical cells in Epstein-Barr virus infection may be problematic but these are usually interfollicular with preservation of germinal centers.

Epstein-Barr Virus infection ; Epstein-Barr Virus Related Malignant Tumours

Isolated cervical adenopathy is the commonest presentation of atypical mycobacterial infection in children, who are otherwise well.

Differentiation from tuberculosis is important, as the treatment is different.  Mycobacterium Tuberculosis

Caseating granulomas, serpiginous or stellate are typical. Microabcesses and paucity of well-defined granulomas favour atypical mycobacterial infection.

Cat scratch disease, toxoplasmosis and rarely Kikuchi's disease are also seen. Toxoplasmosis ; Cat Scratch Disease.

The differential diagnosis of sinus histiocytosis and dermatopathic lymphadenopathy includes Langerhans cell histiocytosis and Rosai-Dorfman disease. Langerhans cell histiocytosis (Histiocytosis X)

Metastatic nasopharyngeal carcinoma usually presents in an adolescent as cervical adenopathy, is generally non-keratinizing and cytokeratin positive.

Papillary carcinoma of the thyroid also frequently presents as cervical adenopathy.

Further reading:

Cervical lymphadenopathy in children- incidence and diagnostic management.

Childhood cervical lymphadenopathy.

Suppurative cervical lymphadenitis in children. Review of 45 patients

Diagnosis, management and surgical treatment of non-tuberculous mycobacterial head and neck infection in children. 

Peripheral lymphadenopathy in childhood--recommendations for diagnostic evaluation

The ratio of cervical subacute necrotizing lymphadenitis occupying superficial lymphadenopathy and its clinical findings .

Kikuchi lymphadenitis.A contribution to the differential diagnosis of cervical lymph node swelling of unknown origin.

Infectious cervical adenopathy

Diagnostic evaluation of cervical adenopathies in childhood .

Neck masses in childhood. Surgical experience in 154 cases.

Pediatrics: cervical adenopathy in children.

Kawasaki disease and cervical adenopathy.



Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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