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

  • Giuseppe RivaEmail author
  • Matteo Sensini
  • Federica Peradotto
  • Carlo Scolfaro
  • Gianpaolo Di Rosa
  • Paolo Tavormina
Original Article

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.

Keywords

Neck mass Children Cysts Lymphadenopathy Pediatric tumors Cat-scratch disease 

Abbreviations

ANOVA

Analysis of variance

PFAPA

Periodic fever, aphthous stomatitis, pharyngitis, adenitis

SPSS

Statistical Package for Social Sciences

Notes

Authors’ contributions

Giuseppe Riva: data collection and analysis and writing of the manuscript. Matteo Sensini: data collection and analysis. Federica Peradotto: data collection and analysis. Carlo Scolfaro: review of the manuscript. Gianpaolo Di Rosa: review of the manuscript. Paolo Tavormina: review of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Curtis WJ, Edwards SP (2015) Pediatric neck masses. Atlas Oral Maxillofac Surg Clin North Am 23:15–20CrossRefGoogle Scholar
  2. 2.
    Lucumay EM, Gilyoma JM, Rambau PF, Chalya PL (2014) Paediatric neck masses at a university teaching hospital in northwestern Tanzania: a prospective analysis of 148 cases. BMC Res Notes 7:772CrossRefGoogle Scholar
  3. 3.
    Malik A, Odita J, Rodriguez J, Hardjasudarma M (2002) Pediatric neck masses: a pictorial review for practicing radiologists. Curr Probl Diagn Radiol 31:146–157CrossRefGoogle Scholar
  4. 4.
    Leung AK, Robson WL (2004) Childhood cervical lymphadenopathy. J Pediatr Health Care 18:3–7CrossRefGoogle Scholar
  5. 5.
    Gosche JR, Vick L (2006) Acute, subacute, and chronic cervical lymphadenitis in children. Semin Pediatr Surg 15:99–106CrossRefGoogle Scholar
  6. 6.
    Gov-Ari E, Hopewell BL (2015) Correlation between pre-operative diagnosis and post-operative pathology reading in pediatric neck masses - a review of 281 cases. Int J Pediatr Otorhinolaryngol 79:2–7CrossRefGoogle Scholar
  7. 7.
    Showkat SA, Lateef M, Wani AA, Lone SA, Singh K, Yousuf I (2009) Clinicopathological profile of cervicofacial masses in pediatric patients. Indian J Otolaryngol Head Neck Surg 61:141–146CrossRefGoogle Scholar
  8. 8.
    Shengwei H, Zhiyong W, Wei H, Qingang H (2015) The management of pediatric neck masses. J Craniofac Surg 26:399–401CrossRefGoogle Scholar
  9. 9.
    Al-Khateeb TH, Al Zoubi F (2007) Congenital neck masses: a descriptive retrospective study of 252 cases. J Oral Maxillofac Surg 65:2242–2247CrossRefGoogle Scholar
  10. 10.
    Citak EC, Koku N, Demirci M, Tanyeri B, Deniz H (2011) A retrospective chart review of evaluation of the cervical lymphadenopathies in children. Auris Nasus Larynx 38:618–621CrossRefGoogle Scholar
  11. 11.
    Kadom N, Lee EY (2012) Neck masses in children: current imaging guidelines and imaging findings. Semin Roentgenol 47:7–20CrossRefGoogle Scholar
  12. 12.
    Anne S, Teot LA, Mandell DL (2008) Fine needle aspiration biopsy: role in diagnosis of pediatric head and neck masses. Int J Pediatr Otorhinolaryngol 72:1547–1553CrossRefGoogle Scholar
  13. 13.
    D'Anza B, Kraseman SJ, Canto-Helwig C, Greene JS, Wood WE (2015) FNA biopsy of pediatric cervicofacial masses and validation of clinical characteristics of malignancy. Int J Pediatr Otorhinolaryngol 79:1196–1200CrossRefGoogle Scholar
  14. 14.
    Charron MP, Abela A, Arcand P, Giguère C, Lapointe A, Quintal M, Cavel O, Froehlich P (2014) Histology of solid lateral cervical masses biopsied in children. Int J Pediatr Otorhinolaryngol 78:39–45CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Pediatric Otorhinolaryngology, Department of PediatricsOspedale Infantile Regina MargheritaTurinItaly
  2. 2.Infectious Diseases Unit, Department of PediatricsOspedale Infantile Regina MargheritaTurinItaly
  3. 3.Pediatric Radiology, Department of PediatricsOspedale Infantile Regina MargheritaTurinItaly

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