All issues > Volume 26(4); 1983

Original Article

J Korean Pediatr Soc. 1983;26(4):366-372. Published online April 30, 1983.

Clinical Analysis of Cervical Masses in Infants and Children.

Dae Young Hwang¹, Do Seung Lee¹, Jeung Sick Min¹, Jae Sun Park¹

¹Department of Pediatrics, Kosin Medical College, Gospel Hospital, Busan，Korea

Abstract

Cervical masses are encountered frequently in pediatric practice. Hardly an upper respiratory infection occurs without lymphadenopathy and many of these enlarged lymph nodes persist for disturbingly long periods of time. Scattered among these innocent cervical masses are those which ultimately are found to be dangerous. Sooner or later, the persistent cervical mass becomes a problem in diagnosis and treatment.In order to elucidate the nature and etiologic disease of cervical masses in the pediatric age in Korea, we reviewed 132 patients under the age 15, who have undergone cervical biopsy and pathological examination in the period of 10 years from Jan. 1972 to Dec. 1981 at Busan Gospel Hospital. The results were as follows: 1) In the pathological analysis of lesions, the most common lesion was nonspecific lymphadenitis (24.2%). The next common lesions were tuberculous lymphadenitis (15.2%), thyrogl ossal duct cyst(9.8%), and cystic hygroma (9.1%) in descending order of frequency. 2. Nonspecific lymphadenitis and miscellaneous benign lesions showed a male preponderance. Tuberculous lymphadenitis, congenital lesions and thyroid masses showed a female prepond trance. Most lesions increased in frequency as the age increased. 3) Most lesions, especially those of congenital origin and benign and malignant masses, were located unilaterally rather than bilaterally. All cases of thyroglossal duct cyst and thyroid mass presented as a solitary mass and involved the midline of the neck. 4) The size of the mass is very significant in clinical evaluation. Among the 46 cases of small sized mass (2 cm. or below in the longest diameter of the mass), there were 15 casesof nonspecific lymphadenitis. Congenital lesions, miscellaneous benign lesions and tuberculous lymphadenitis were found in 15,12, and 3 cases respectively. Malignant tumor was revealed in only one case, which was suspected before biopsy. 5)The duration of most cervical masses by history was not confirmable and showed wide variance even within each disease. 6) In our study, a specific cause for the cervical mass was found after pathological examination in 75.8% of 132 cases. The others, which comprised 24.2% of all cases, were found to be nonspecific lymphadenitis or reactive hyperaspila of cervical lymph node of obscure etiology. These latter children were predominantly male patients above the age of 6 and small cervical masses (below 2 cm. in diameter). Finally in review of literature and our experience, it seems resonable that children with cervical masses without involvement of the supraclavicular or lower cervical region, who are apparently in no distress, and have a mass diameter below 2 cm. may be observed over several weeks or months without danger. In Korea, tuberculous lymphadenitis should be suspected in some cases, however, and routine study for detecting lymphatic or extralymphatic tuberculosis should be done.

Keywords :Nonspecific lymphadenitis; cervical masses.