Predictors of malignancy in childhood peripheral lymphadenopathy

J Pediatr Surg. 1999 Oct;34(10):1447-52. doi: 10.1016/s0022-3468(99)90101-x.


Purpose: The aim of this study was to identify factors associated with malignant etiologies of childhood peripheral lymphadenopathy and to construct a model that may be used to assess the risk of malignancy.

Methods: The medical records of 60 consecutive patients 18 years old or less who underwent peripheral lymph node biopsies were reviewed.

Results: Increasing node size, number of sites of adenopathy, and age were associated with an increasing risk of malignancy (P < .05 for all variables). Graphs useful for risk determination were constructed based on these variables. Additional factors associated with malignancy included the presence of supraclavicular adenopathy (P < .01), an abnormal chest x-ray (P < .01), and fixed nodes (P < .01). Variables that were not statistically different between patients with benign and malignant adenopathy included the duration of adenopathy (P = .43), the presence of fever (P = .36), cough (P = .14), splenomegaly (P = .93), skin involvement (P = .39), tenderness (P = .49), and bilateral adenopathy (P = .39). Fluctuance was associated with benign adenopathy (P < .04).

Conclusions: The risk of malignancy increased with increasing size and number of sites of adenopathy and age. Other significant predictors of malignancy included supraclavicular location, an abnormal chest x-ray, and fixed nodes. These data may be used to supplement clinical judgment to predict the risk of malignancy.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Child
  • Female
  • Humans
  • Logistic Models
  • Lymphatic Diseases / etiology*
  • Male
  • Neoplasms / complications
  • Neoplasms / epidemiology*
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors