FINE-NEEDLE ASPIRATION IN THE EVALUATION OF CHILDREN WITH LYMPHADENOPATHY

Objective: To evaluate fine needle aspiration of enlarged lymph nodes in children. Design: Retrospective study of children who were referred for fine needle aspiration of a palpable lymph node that was of concern to their clinicians. Setting: Large, urban, tertiary care pediatric hospital. Subjects: One hundred nineteen patients (123 cases) aged 10 months through 21 years during the 30-month period from January 1990 to June 1992. Results: Aspirated material in 13 cases (10.6%) was deemed inadequate for cytologic diagnosis. In the remaining 110 cases, five aspirates revealed malignancy: two patients had Hodgkin's disease, one had non-Hodgkin's lymphoma, one had a leukemic infiltrate, and one had rhabdomyosarcoma. The findings in two cases were suspicious for malignancy, but the lymph nodes were found to be benign on excisional biopsy. No false-negative findings for malignancy were detected. The conditions of patients in the remaining 103 cases were diagnosed as a benign process, most commonly reactive lymphadenitis. Of 57 aspirates cultured, eight (14%) were positive for a microorganism. No significant complications were encountered in any of the 123 cases. Conclusion: Fine needle aspiration of enlarged lymph nodes in children is a safe, reliable (accuracy, 98%) procedure that often obviates the need for an excisional biopsy.