| Clinical Investigation of Neck Masses in Children |
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Sung Chul Byun, Dong Soo Kim |
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Department of Pediatrics, Yonsei University Medical College, Seoul, Korea |
| 소아 경부 종괴의 임상적 고찰 |
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변성철, 김동수 |
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연세대학교 의과대학 소아과학교실 |
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| Abstract |
Purpose
: Neck masses are frequently encountered in pediatric practice, and have various
underlying diseases. If the underlying diseases of the neck mass are not confirmed by its clinical
characteristics, it can be done by neck mass biopsy. To define the necessity and the appropriate
time of neck mass biopsy is very difficult and also important. Therefore the authers have
conducted this study to have aids in differential diagnosis of neck mass in children by analyzing
the clinical manifestations of underlying diseases of neck mass.
Methods
: The authors have reviewed 390 children under 15 years of age who visited and
admitted with neck masses to Shinchon Severance Hospital between Jan. 1987 and Dec. 1994. In
order to elucidate the nature and etiologic diseases of neck masses, we classify and analyze the
neck masses by age and sex distribution, duration of symptoms and signs, size and consistencies
and by site and number of neck masses, and finally by underlying diseases.
Results
:
1) Of the overall sex distribution, male patients were more than female, the male to female
ratio was 1.32 : 1(222:168). The most common age group was 2-5 years of age. The most
common acompanying symptoms were upper respiratory tract infection symptoms, comprising 37.7
% of all, and the most common duration of symptoms and signs was within 3 months,
comprising 65.6 % of all.
2) Of the underlying diseases of the neck masses, the largest proportions were inflammatory
masses, which comprising 49.2 % of all cases, among these, nonspecific cervical lymphadenitis
was most common(65.6 %).
3) We could also confirm the nonspecific cervical lymphadenitis by clinical manifestations,
blood exams and neck ultrasonography except neck mass biopsy.
4) For the diagnosis of tuberculous lymphadenitis, the family history of tuberculosis, PPD skin
test, and chest X- ray findings are almost helpful, but the neck mass biopsy was essential.
5) Malignant tumors were 24 cases, which comprise 6.2 % of all.
Conclusion
: For the appropriate differential diagnosis of neck masses in children, we should
observe and describe accurately the clinical characteristics of the neck masses. On physical
examination, if we can not rule out the possibility of tuberculous lymphadenitis or malignant
tumors, the neck mass biopsy should be done immediately, but if it is likely the nonspecific
cervical lymphadenitis, we must wait until the size of neck masses decrease or other symptoms
disappear after empirical antibiotics therapy. |
| Key Words:
Neck mass, Nonspecific cervical lymphadenitis |
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