Дифференциальная диагностика лимфаденопатий у детей
Дифференциальная диагностика лимфаденопатий у детей
Наумова А.С., Тиганова О.А., Ильенко Л.И. Дифференциальная диагностика лимфаденопатий у детей. Педиатрия. Consilium Medicum. 2019; 2: 32–38.
DOI: 10.26442/26586630.2019.2.190364
Naumova A.S., Tiganova O.A., Ilienko L.I. Differential diagnostics of lymphadenopathy in children. Pediatrics. Consilium Medicum. 2019; 2: 32–38.
DOI: 10.26442/26586630.2019.2.190364
DOI: 10.26442/26586630.2019.2.190364
________________________________________________
Naumova A.S., Tiganova O.A., Ilienko L.I. Differential diagnostics of lymphadenopathy in children. Pediatrics. Consilium Medicum. 2019; 2: 32–38.
DOI: 10.26442/26586630.2019.2.190364
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Аннотация
Проблема дифференциального диагноза лимфаденопатий (ЛАП) имеет большое значение для врачей многих специальностей, включая педиатров, инфекционистов, хирургов, гематологов, онкологов. Локальное увеличение лимфатических узлов часто является следствием инфекции дренируемых зон и может быть быстро диагностировано при наличии первичного очага инфекции. В случае генерализованной ЛАП целесообразен диагностический поиск в отношении системного инфекционного процесса, аутоиммунного заболевания, злокачественного новообразования. Задачей любого врача, обследующего ребенка с ЛАП, является верификация нозологического диагноза. Для этого необходимы детальный сбор анамнеза, тщательное физикальное обследование пациента, использование лабораторных и инструментальных методов диагностики, своевременное принятие решения о необходимости проведения биопсии увеличенного лимфатического узла. В 13–15% случаев выполненных биопсий у детей гистологически подтверждается онкологический процесс, при этом более 1/2 из них приходится на лимфому Ходжкина. Поэтому до выяснения причины ЛАП необходимо воздерживаться от применения стероидных гормонов, поскольку глюкокортикоиды маскируют течение злокачественного процесса.
Ключевые слова: лимфаденопатия, лимфаденит, лимфатические узлы, диагностика, лимфома Ходжкина, дети.
The evaluation of the child with lymphadenopathy is a common clinical case for the pediatricians, including infectiologists, surgeons, hematologists, oncologists. Localized lymphadenopathy often is caused by infection of the particular area according to lymphatic drainage patterns. Generalized lymphadenopathy often indicates underlying systemic infectious disease, autoimmune disease or malignancy. The aim of any pediatrician who examines a child with lymphadenopathy is the verification of a nosological diagnosis. For this purpose history, physical examination, laboratory evaluation, radiologic evaluation, adequate biopsy are essential. Malignancy is discovered in 13–15% of the biopsies, and Hodgkin disease constitutes more the half of the malignancies. Therefore the therapy with glucocorticoids should be avoided until a definitive diagnosis is made, because they will mask and delay the diagnosis of leukemia and lymphomas.
Key words: lymphadenopathy, lymphadenitis, lymph nodes, diagnostics, Hodgkin’s lymphoma, children.
Ключевые слова: лимфаденопатия, лимфаденит, лимфатические узлы, диагностика, лимфома Ходжкина, дети.
________________________________________________
The evaluation of the child with lymphadenopathy is a common clinical case for the pediatricians, including infectiologists, surgeons, hematologists, oncologists. Localized lymphadenopathy often is caused by infection of the particular area according to lymphatic drainage patterns. Generalized lymphadenopathy often indicates underlying systemic infectious disease, autoimmune disease or malignancy. The aim of any pediatrician who examines a child with lymphadenopathy is the verification of a nosological diagnosis. For this purpose history, physical examination, laboratory evaluation, radiologic evaluation, adequate biopsy are essential. Malignancy is discovered in 13–15% of the biopsies, and Hodgkin disease constitutes more the half of the malignancies. Therefore the therapy with glucocorticoids should be avoided until a definitive diagnosis is made, because they will mask and delay the diagnosis of leukemia and lymphomas.
Key words: lymphadenopathy, lymphadenitis, lymph nodes, diagnostics, Hodgkin’s lymphoma, children.
Список литературы
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9. Friedmann AM. Evaluation and management of lymphadenopathy in children. Pediatr Rev 2008; 29: 53.
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17. Rajasekaran K, Krakovitz P. Enlarged neck lymph nodes in children. Pediatr Clin North Am 2013; 60 (4): 923–36.
18. Meier JD, Grimmer JF. Evaluation and management of neck masses in children. Am Fam Physician 2014; 89 (5): 353–8.
19. Spyridis P, Maltezou H, Hantzakos A et al. Mycobacterial cervical lymphadenitis in children: Clinical and laboratory factors of importance for differential diagnosis. Scand J Infect Dis 2001; 33: 362–6.
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21. Rosenberg TL, Nolder AR. Pediatric cervical lymphadenopathy. Otolaryngol Clin North Am 2014; 47 (5): 721–31.
22. Rosa PA, Hirsch DL, Dierks EJ. Congenital neck masses. Oral Maxillofacial Surg Clin N Am 2008; 20: 339–52.
23. Tracy TF, Muratore CS. Management of common head and neck masses. Sem Ped Surg 2007; 16: 3–13.
24. Oguz A, Karadenız C, Temel EA et al. Evaluation of peripheral lymphadenopathy in children. Pediatr Hematol Oncol 2006; 23: 549–61.
25. Lennon P, Crotty M, Fenton JE. Infectious mononucleosis. BMJ 2015; 350: h1825.
26. King D, Ramachandra J, Yeomanson D. Lymphadenopathy in children: refer or reassure? Arch Dis Child Educ Pract Ed 2014; 99: 101–10.
27. Brown JR, Skarin AT. Clinical mimics of lymphoma. Oncologist 2004; 9 (4): 406–16.
28. Monaco SE, Khalbuss WE, Pantanowitz L. Benign non-infectious causes of lymphadenopathy: A review of cytomorphology and differentialdiagnosis. Diagn Cytopathol 2012; 40 (10): 925–38.
29. Saif MW. Diagnosis and treatment of Kaposi’s sarcoma. Resid Staff Physician 2001; 47: 19–24.
30. Özkan EA, Göret CC, Özdemir ZT et al. Evaluation of peripheral lymphadenopathy with excisional biopsy: six-year experience. Int J Clin Exp Pathol 2015; 8 (11): 15234–9.
31. Raab CP, Gartner JC Jr. Diagnosis of childhood cancer. Prim Care Clin Office Pract 2009; 36: 671–84.
32. Fragkandrea I, Nixon JA, Panagopoulou P. Signs and symptoms of childhood cancer: a guide for early recognition. Am Fam Physician 2013; 88 (3): 185–92.
33. Mitchell C, Hall G, Clarke RT. Acute leukaemia in children: diagnosis and management. BMJ 2009; 338: b2285.
34. Bernbeck B, Wüller D, Janssen G et al. Symptoms of childhood acute lymphoblastic leukemia: red flags to recognize leukemia in dailypractice. Klin Padiatr 2009; 221 (6): 369–73.
35. Citak EC, Koku N, Demirci M et al. A retrospective chart review of evaluation of the cervical lymphadenopathies in children. Auris Nasus Larynx 2011; 38: 618–21.
36. Gwili NM, Hadi MA, Eldin AN et al. Lymphadenopathy in a series of Egyptian pediatric patients and the role of pathology in the diagnostic workup. Pediatr Dev Pathol 2014; 17 (5): 344–5.
37. Vargas-Vallejo MdelP, Alvarez-Solis RM, Juarez-Quintal M et al. Clinical factors that predict malignancy in cervical lymph node biopsies. Rev Med Inst Mex Seguro Soc 2007; 45: 389–94.
38. Wang J, Pei G, Yan J et al. Unexplained cervical lymphadenopathy in children: predictive factors for malignancy. J Pediatr Surg 2010; 45 (4): 784–8.
39. Darnal HK, Karim N, Kamini K, Angela K. The profile of lymphadenopathy in adults and children. Med J Malaysia 2005; 60 (5): 590–8.
40. Nolder AR. Paediatric cervical lymphadenopathy: when to biopsy. Curr Opin Otolaryngol Head Neck Surg 2013; 21 (6): 567–70.
2. Mohseni S, Shojaiefard A, Khorgami Z et al. Peripheral lymphadenopathy: approach and diagnostic tools. Iran J Med Sci 2014; 39 (Suppl. 2): 158–70.
3. Celenk F, Baysal E, Aytac I et al. Incidence and predictors of malignancy in children with persistent cervical lymphadenopathy. Int J Pediatr Otorhinolaringol 2013; 77: 2004–7.
4. Bazemore AW, Smuker DR. Lymphadenopathy and malignancy. Am Fam Physician 2002; 66: 2103–10.
5. Gaddey HL, Riegel AM. Unexplained lymphadenopathy: evaluation and differential diagnosis. Am Fam Physician 2016; 94 (11): 896–903.
6. Nield LS, Kamat D. Lymphadenopathy in children: when and how to evaluate. Clin Pediatr 2004; 43: 25–33.
7. Gosche JR, Vick L. Acute, subacute, and chronic cervical lymphadenitis in children. Semin Pediatr Surg 2006; 15 (2): 99–106.
8. Magarelli N, Guglielmi G, Savastano M et al. Superficial inflammatory and primary neoplastic lymphadenopathy: diagnostic accuracy of power-doppler sonography. Eur J Radiol 2004; 52 (3): 257–63.
9. Friedmann AM. Evaluation and management of lymphadenopathy in children. Pediatr Rev 2008; 29: 53.
10. Sahai S. Lymphadenopathy. Pediatr Rev 2013; 34: 216.
11. Habermann TM, Steensma DP. Lymphadenopathy. Mayo Clin Proc 2000; 75: 723–32.
12. Twist CJ, Link MP. Assessment of lymphadenopathy in children. Pediatr Clin North Am 2002; 49: 1009–25.
13. Leung AK, Robson WL. Childhood cervical lymphadenopathy. J Pediatr Health Care 2004; 18 (1): 3–7.
14. Moore SW, Schneider JW, Schaaf HS. Diagnostic aspects of cervical lymphadenopathy in children in the developing world: a study of 1877 surgical specimens. Pediatr Surg Int 2003; 19: 240–4.
15. Goins MR, Beasley MS. Pediatric neck masses. Oral Maxillofacial Surg Clin N Am 2012; 24: 457–68.
16. Peters TR, Edwards KМ. Cervical lymphadenopathy and adenitis. Pediatr Rev 2000; 21: 399–404.
17. Rajasekaran K, Krakovitz P. Enlarged neck lymph nodes in children. Pediatr Clin North Am 2013; 60 (4): 923–36.
18. Meier JD, Grimmer JF. Evaluation and management of neck masses in children. Am Fam Physician 2014; 89 (5): 353–8.
19. Spyridis P, Maltezou H, Hantzakos A et al. Mycobacterial cervical lymphadenitis in children: Clinical and laboratory factors of importance for differential diagnosis. Scand J Infect Dis 2001; 33: 362–6.
20. Mazur-Melewska K, Mania A, Kemnitz P et al. Cat-scratch disease: a wide spectrum of clinical pictures. Postepy Dermatol Alergol 2015; 32 (3): 216–20.
21. Rosenberg TL, Nolder AR. Pediatric cervical lymphadenopathy. Otolaryngol Clin North Am 2014; 47 (5): 721–31.
22. Rosa PA, Hirsch DL, Dierks EJ. Congenital neck masses. Oral Maxillofacial Surg Clin N Am 2008; 20: 339–52.
23. Tracy TF, Muratore CS. Management of common head and neck masses. Sem Ped Surg 2007; 16: 3–13.
24. Oguz A, Karadenız C, Temel EA et al. Evaluation of peripheral lymphadenopathy in children. Pediatr Hematol Oncol 2006; 23: 549–61.
25. Lennon P, Crotty M, Fenton JE. Infectious mononucleosis. BMJ 2015; 350: h1825.
26. King D, Ramachandra J, Yeomanson D. Lymphadenopathy in children: refer or reassure? Arch Dis Child Educ Pract Ed 2014; 99: 101–10.
27. Brown JR, Skarin AT. Clinical mimics of lymphoma. Oncologist 2004; 9 (4): 406–16.
28. Monaco SE, Khalbuss WE, Pantanowitz L. Benign non-infectious causes of lymphadenopathy: A review of cytomorphology and differentialdiagnosis. Diagn Cytopathol 2012; 40 (10): 925–38.
29. Saif MW. Diagnosis and treatment of Kaposi’s sarcoma. Resid Staff Physician 2001; 47: 19–24.
30. Özkan EA, Göret CC, Özdemir ZT et al. Evaluation of peripheral lymphadenopathy with excisional biopsy: six-year experience. Int J Clin Exp Pathol 2015; 8 (11): 15234–9.
31. Raab CP, Gartner JC Jr. Diagnosis of childhood cancer. Prim Care Clin Office Pract 2009; 36: 671–84.
32. Fragkandrea I, Nixon JA, Panagopoulou P. Signs and symptoms of childhood cancer: a guide for early recognition. Am Fam Physician 2013; 88 (3): 185–92.
33. Mitchell C, Hall G, Clarke RT. Acute leukaemia in children: diagnosis and management. BMJ 2009; 338: b2285.
34. Bernbeck B, Wüller D, Janssen G et al. Symptoms of childhood acute lymphoblastic leukemia: red flags to recognize leukemia in dailypractice. Klin Padiatr 2009; 221 (6): 369–73.
35. Citak EC, Koku N, Demirci M et al. A retrospective chart review of evaluation of the cervical lymphadenopathies in children. Auris Nasus Larynx 2011; 38: 618–21.
36. Gwili NM, Hadi MA, Eldin AN et al. Lymphadenopathy in a series of Egyptian pediatric patients and the role of pathology in the diagnostic workup. Pediatr Dev Pathol 2014; 17 (5): 344–5.
37. Vargas-Vallejo MdelP, Alvarez-Solis RM, Juarez-Quintal M et al. Clinical factors that predict malignancy in cervical lymph node biopsies. Rev Med Inst Mex Seguro Soc 2007; 45: 389–94.
38. Wang J, Pei G, Yan J et al. Unexplained cervical lymphadenopathy in children: predictive factors for malignancy. J Pediatr Surg 2010; 45 (4): 784–8.
39. Darnal HK, Karim N, Kamini K, Angela K. The profile of lymphadenopathy in adults and children. Med J Malaysia 2005; 60 (5): 590–8.
40. Nolder AR. Paediatric cervical lymphadenopathy: when to biopsy. Curr Opin Otolaryngol Head Neck Surg 2013; 21 (6): 567–70.
[Limfomy u detei: prakticheskoe rukovodstvo. Pod red. G.L.Mentkevich, S.A.Maiakovoi. Moscow: Prakticheskaia meditsina, 2014 (in Russian).]
2. Mohseni S, Shojaiefard A, Khorgami Z et al. Peripheral lymphadenopathy: approach and diagnostic tools. Iran J Med Sci 2014; 39 (Suppl. 2): 158–70.
3. Celenk F, Baysal E, Aytac I et al. Incidence and predictors of malignancy in children with persistent cervical lymphadenopathy. Int J Pediatr Otorhinolaringol 2013; 77: 2004–7.
4. Bazemore AW, Smuker DR. Lymphadenopathy and malignancy. Am Fam Physician 2002; 66: 2103–10.
5. Gaddey HL, Riegel AM. Unexplained lymphadenopathy: evaluation and differential diagnosis. Am Fam Physician 2016; 94 (11): 896–903.
6. Nield LS, Kamat D. Lymphadenopathy in children: when and how to evaluate. Clin Pediatr 2004; 43: 25–33.
7. Gosche JR, Vick L. Acute, subacute, and chronic cervical lymphadenitis in children. Semin Pediatr Surg 2006; 15 (2): 99–106.
8. Magarelli N, Guglielmi G, Savastano M et al. Superficial inflammatory and primary neoplastic lymphadenopathy: diagnostic accuracy of power-doppler sonography. Eur J Radiol 2004; 52 (3): 257–63.
9. Friedmann AM. Evaluation and management of lymphadenopathy in children. Pediatr Rev 2008; 29: 53.
10. Sahai S. Lymphadenopathy. Pediatr Rev 2013; 34: 216.
11. Habermann TM, Steensma DP. Lymphadenopathy. Mayo Clin Proc 2000; 75: 723–32.
12. Twist CJ, Link MP. Assessment of lymphadenopathy in children. Pediatr Clin North Am 2002; 49: 1009–25.
13. Leung AK, Robson WL. Childhood cervical lymphadenopathy. J Pediatr Health Care 2004; 18 (1): 3–7.
14. Moore SW, Schneider JW, Schaaf HS. Diagnostic aspects of cervical lymphadenopathy in children in the developing world: a study of 1877 surgical specimens. Pediatr Surg Int 2003; 19: 240–4.
15. Goins MR, Beasley MS. Pediatric neck masses. Oral Maxillofacial Surg Clin N Am 2012; 24: 457–68.
16. Peters TR, Edwards KМ. Cervical lymphadenopathy and adenitis. Pediatr Rev 2000; 21: 399–404.
17. Rajasekaran K, Krakovitz P. Enlarged neck lymph nodes in children. Pediatr Clin North Am 2013; 60 (4): 923–36.
18. Meier JD, Grimmer JF. Evaluation and management of neck masses in children. Am Fam Physician 2014; 89 (5): 353–8.
19. Spyridis P, Maltezou H, Hantzakos A et al. Mycobacterial cervical lymphadenitis in children: Clinical and laboratory factors of importance for differential diagnosis. Scand J Infect Dis 2001; 33: 362–6.
20. Mazur-Melewska K, Mania A, Kemnitz P et al. Cat-scratch disease: a wide spectrum of clinical pictures. Postepy Dermatol Alergol 2015; 32 (3): 216–20.
21. Rosenberg TL, Nolder AR. Pediatric cervical lymphadenopathy. Otolaryngol Clin North Am 2014; 47 (5): 721–31.
22. Rosa PA, Hirsch DL, Dierks EJ. Congenital neck masses. Oral Maxillofacial Surg Clin N Am 2008; 20: 339–52.
23. Tracy TF, Muratore CS. Management of common head and neck masses. Sem Ped Surg 2007; 16: 3–13.
24. Oguz A, Karadenız C, Temel EA et al. Evaluation of peripheral lymphadenopathy in children. Pediatr Hematol Oncol 2006; 23: 549–61.
25. Lennon P, Crotty M, Fenton JE. Infectious mononucleosis. BMJ 2015; 350: h1825.
26. King D, Ramachandra J, Yeomanson D. Lymphadenopathy in children: refer or reassure? Arch Dis Child Educ Pract Ed 2014; 99: 101–10.
27. Brown JR, Skarin AT. Clinical mimics of lymphoma. Oncologist 2004; 9 (4): 406–16.
28. Monaco SE, Khalbuss WE, Pantanowitz L. Benign non-infectious causes of lymphadenopathy: A review of cytomorphology and differentialdiagnosis. Diagn Cytopathol 2012; 40 (10): 925–38.
29. Saif MW. Diagnosis and treatment of Kaposi’s sarcoma. Resid Staff Physician 2001; 47: 19–24.
30. Özkan EA, Göret CC, Özdemir ZT et al. Evaluation of peripheral lymphadenopathy with excisional biopsy: six-year experience. Int J Clin Exp Pathol 2015; 8 (11): 15234–9.
31. Raab CP, Gartner JC Jr. Diagnosis of childhood cancer. Prim Care Clin Office Pract 2009; 36: 671–84.
32. Fragkandrea I, Nixon JA, Panagopoulou P. Signs and symptoms of childhood cancer: a guide for early recognition. Am Fam Physician 2013; 88 (3): 185–92.
33. Mitchell C, Hall G, Clarke RT. Acute leukaemia in children: diagnosis and management. BMJ 2009; 338: b2285.
34. Bernbeck B, Wüller D, Janssen G et al. Symptoms of childhood acute lymphoblastic leukemia: red flags to recognize leukemia in dailypractice. Klin Padiatr 2009; 221 (6): 369–73.
35. Citak EC, Koku N, Demirci M et al. A retrospective chart review of evaluation of the cervical lymphadenopathies in children. Auris Nasus Larynx 2011; 38: 618–21.
36. Gwili NM, Hadi MA, Eldin AN et al. Lymphadenopathy in a series of Egyptian pediatric patients and the role of pathology in the diagnostic workup. Pediatr Dev Pathol 2014; 17 (5): 344–5.
37. Vargas-Vallejo MdelP, Alvarez-Solis RM, Juarez-Quintal M et al. Clinical factors that predict malignancy in cervical lymph node biopsies. Rev Med Inst Mex Seguro Soc 2007; 45: 389–94.
38. Wang J, Pei G, Yan J et al. Unexplained cervical lymphadenopathy in children: predictive factors for malignancy. J Pediatr Surg 2010; 45 (4): 784–8.
39. Darnal HK, Karim N, Kamini K, Angela K. The profile of lymphadenopathy in adults and children. Med J Malaysia 2005; 60 (5): 590–8.
40. Nolder AR. Paediatric cervical lymphadenopathy: when to biopsy. Curr Opin Otolaryngol Head Neck Surg 2013; 21 (6): 567–70.
________________________________________________
2. Mohseni S, Shojaiefard A, Khorgami Z et al. Peripheral lymphadenopathy: approach and diagnostic tools. Iran J Med Sci 2014; 39 (Suppl. 2): 158–70.
3. Celenk F, Baysal E, Aytac I et al. Incidence and predictors of malignancy in children with persistent cervical lymphadenopathy. Int J Pediatr Otorhinolaringol 2013; 77: 2004–7.
4. Bazemore AW, Smuker DR. Lymphadenopathy and malignancy. Am Fam Physician 2002; 66: 2103–10.
5. Gaddey HL, Riegel AM. Unexplained lymphadenopathy: evaluation and differential diagnosis. Am Fam Physician 2016; 94 (11): 896–903.
6. Nield LS, Kamat D. Lymphadenopathy in children: when and how to evaluate. Clin Pediatr 2004; 43: 25–33.
7. Gosche JR, Vick L. Acute, subacute, and chronic cervical lymphadenitis in children. Semin Pediatr Surg 2006; 15 (2): 99–106.
8. Magarelli N, Guglielmi G, Savastano M et al. Superficial inflammatory and primary neoplastic lymphadenopathy: diagnostic accuracy of power-doppler sonography. Eur J Radiol 2004; 52 (3): 257–63.
9. Friedmann AM. Evaluation and management of lymphadenopathy in children. Pediatr Rev 2008; 29: 53.
10. Sahai S. Lymphadenopathy. Pediatr Rev 2013; 34: 216.
11. Habermann TM, Steensma DP. Lymphadenopathy. Mayo Clin Proc 2000; 75: 723–32.
12. Twist CJ, Link MP. Assessment of lymphadenopathy in children. Pediatr Clin North Am 2002; 49: 1009–25.
13. Leung AK, Robson WL. Childhood cervical lymphadenopathy. J Pediatr Health Care 2004; 18 (1): 3–7.
14. Moore SW, Schneider JW, Schaaf HS. Diagnostic aspects of cervical lymphadenopathy in children in the developing world: a study of 1877 surgical specimens. Pediatr Surg Int 2003; 19: 240–4.
15. Goins MR, Beasley MS. Pediatric neck masses. Oral Maxillofacial Surg Clin N Am 2012; 24: 457–68.
16. Peters TR, Edwards KМ. Cervical lymphadenopathy and adenitis. Pediatr Rev 2000; 21: 399–404.
17. Rajasekaran K, Krakovitz P. Enlarged neck lymph nodes in children. Pediatr Clin North Am 2013; 60 (4): 923–36.
18. Meier JD, Grimmer JF. Evaluation and management of neck masses in children. Am Fam Physician 2014; 89 (5): 353–8.
19. Spyridis P, Maltezou H, Hantzakos A et al. Mycobacterial cervical lymphadenitis in children: Clinical and laboratory factors of importance for differential diagnosis. Scand J Infect Dis 2001; 33: 362–6.
20. Mazur-Melewska K, Mania A, Kemnitz P et al. Cat-scratch disease: a wide spectrum of clinical pictures. Postepy Dermatol Alergol 2015; 32 (3): 216–20.
21. Rosenberg TL, Nolder AR. Pediatric cervical lymphadenopathy. Otolaryngol Clin North Am 2014; 47 (5): 721–31.
22. Rosa PA, Hirsch DL, Dierks EJ. Congenital neck masses. Oral Maxillofacial Surg Clin N Am 2008; 20: 339–52.
23. Tracy TF, Muratore CS. Management of common head and neck masses. Sem Ped Surg 2007; 16: 3–13.
24. Oguz A, Karadenız C, Temel EA et al. Evaluation of peripheral lymphadenopathy in children. Pediatr Hematol Oncol 2006; 23: 549–61.
25. Lennon P, Crotty M, Fenton JE. Infectious mononucleosis. BMJ 2015; 350: h1825.
26. King D, Ramachandra J, Yeomanson D. Lymphadenopathy in children: refer or reassure? Arch Dis Child Educ Pract Ed 2014; 99: 101–10.
27. Brown JR, Skarin AT. Clinical mimics of lymphoma. Oncologist 2004; 9 (4): 406–16.
28. Monaco SE, Khalbuss WE, Pantanowitz L. Benign non-infectious causes of lymphadenopathy: A review of cytomorphology and differentialdiagnosis. Diagn Cytopathol 2012; 40 (10): 925–38.
29. Saif MW. Diagnosis and treatment of Kaposi’s sarcoma. Resid Staff Physician 2001; 47: 19–24.
30. Özkan EA, Göret CC, Özdemir ZT et al. Evaluation of peripheral lymphadenopathy with excisional biopsy: six-year experience. Int J Clin Exp Pathol 2015; 8 (11): 15234–9.
31. Raab CP, Gartner JC Jr. Diagnosis of childhood cancer. Prim Care Clin Office Pract 2009; 36: 671–84.
32. Fragkandrea I, Nixon JA, Panagopoulou P. Signs and symptoms of childhood cancer: a guide for early recognition. Am Fam Physician 2013; 88 (3): 185–92.
33. Mitchell C, Hall G, Clarke RT. Acute leukaemia in children: diagnosis and management. BMJ 2009; 338: b2285.
34. Bernbeck B, Wüller D, Janssen G et al. Symptoms of childhood acute lymphoblastic leukemia: red flags to recognize leukemia in dailypractice. Klin Padiatr 2009; 221 (6): 369–73.
35. Citak EC, Koku N, Demirci M et al. A retrospective chart review of evaluation of the cervical lymphadenopathies in children. Auris Nasus Larynx 2011; 38: 618–21.
36. Gwili NM, Hadi MA, Eldin AN et al. Lymphadenopathy in a series of Egyptian pediatric patients and the role of pathology in the diagnostic workup. Pediatr Dev Pathol 2014; 17 (5): 344–5.
37. Vargas-Vallejo MdelP, Alvarez-Solis RM, Juarez-Quintal M et al. Clinical factors that predict malignancy in cervical lymph node biopsies. Rev Med Inst Mex Seguro Soc 2007; 45: 389–94.
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Авторы
А.С. Наумова*1, О.А. Тиганова1,2, Л.И. Ильенко2
1 ГБУЗ «Морозовская детская городская клиническая больница» Департамента здравоохранения г. Москвы, Москва, Россия;
2 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*alex.naumova@gmail.com
1 Morozov Children Clinical Hospital, Moscow, Russia;
2 Pirogov Russian National Research Medical University, Moscow, Russia
*alex.naumova@gmail.com
1 ГБУЗ «Морозовская детская городская клиническая больница» Департамента здравоохранения г. Москвы, Москва, Россия;
2 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*alex.naumova@gmail.com
________________________________________________
1 Morozov Children Clinical Hospital, Moscow, Russia;
2 Pirogov Russian National Research Medical University, Moscow, Russia
*alex.naumova@gmail.com
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