Affordable Access

Access to the full text

Pediatric neck masses: how clinical and radiological features can drive diagnosis

Authors
  • Riva, Giuseppe1
  • Sensini, Matteo1
  • Peradotto, Federica1
  • Scolfaro, Carlo2
  • Di Rosa, Gianpaolo3
  • Tavormina, Paolo1
  • 1 Ospedale Infantile Regina Margherita, Pediatric Otorhinolaryngology, Department of Pediatrics, Piazza Polonia 94, Turin, 10126, Italy , Turin (Italy)
  • 2 Ospedale Infantile Regina Margherita, Infectious Diseases Unit, Department of Pediatrics, Piazza Polonia 94, Turin, 10126, Italy , Turin (Italy)
  • 3 Ospedale Infantile Regina Margherita, Pediatric Radiology, Department of Pediatrics, Piazza Polonia 94, Turin, 10126, Italy , Turin (Italy)
Type
Published Article
Journal
European Journal of Pediatrics
Publisher
Springer-Verlag
Publication Date
Jan 14, 2019
Volume
178
Issue
4
Pages
463–471
Identifiers
DOI: 10.1007/s00431-018-3305-9
Source
Springer Nature
Keywords
License
Yellow

Abstract

Pediatric neck masses are a common occurrence and often represent a diagnostic challenge. The primary aim of this retrospective study was to evaluate the clinical and radiological features of neck masses in children and how they can drive diagnosis. The secondary aim was to create a diagnostic algorithm based on clinical features. We evaluated 190 children with neck masses who needed hospitalization. Clinical data and imaging findings were collected. The patients were divided into six groups: congenital/developmental lesions, tumors, acute and subacute lymphadenopathies, chronic nonspecific lymphadenopathies, cat-scratch disease, and mycobacteriosis. Reactive lymphadenopathies were observed in the majority of cases (65.8%). Congenital/developmental cysts were present in 28.9%, while 5.3% had a tumor. A lower mean age was observed for acute/subacute lymphadenopathies and mycobacteriosis. Fever and a painful mass were typical of acute/subacute lymphadenopaties and cat-scratch disease. A hard and fixed mass was not only typical of tumors. Concerning imaging findings, multiple lymph nodes at the same level was mainly observed in mycobacteriosis, while bilateral lymph node enlargement and colliquation were present in lymphadenopathies. Conclusion:A complete and adequate clinical assessment should be the basis for every diagnostic and therapeutic choice in children with neck masses.What is Known: • Pediatric neck masses are a common occurrence and often represent a diagnostic challenge. • Clinical features, serological exams and imaging findings should drive the physician to an appropriate diagnostic hypothesis. What is New:• A lower mean age was observed for acute/subacute lymphadenopathies and mycobacteriosis.• A hard and fixed mass was not only typical of tumors.• Multiple lymph nodes at the same level were mainly observed in mycobacteriosis, while bilateral lymph node enlargement and colliquation were present in nonspecific lymphadenopathies.

Report this publication

Statistics

Seen <100 times