Hostname: page-component-8448b6f56d-jr42d Total loading time: 0 Render date: 2024-04-25T05:38:38.842Z Has data issue: false hasContentIssue false
  • English
  • Français

Paediatric neck masses – a diagnostic dilemma

Published online by Cambridge University Press:  29 June 2007

A. A. P. Connolly  and
K. MacKenzie
A. A. P. Connolly
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Glasgow Royal Infirmary, Glasgow, UK.
K. MacKenzie*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Glasgow Royal Infirmary, Glasgow, UK. Departments of Otolarynogology – Head and Neck Surgery, Glasgow Royal Infirmary, and the Royal Hospital for Sick Children, Glasgow, UK.
*
Address for correspondence: Mr K. MacKenzie, M.B., Ch.B., F.R.C.S., Department of Otolaryngology – Head and Neck Surgery, Royal Infirmary, Glasgow G31 2ER. Fax: 0141-211-4896
Get access Rights & Permissions [Opens in a new window]

Abstract

Three hundred and sixty children who had a head and neck mass excised during 1987 to 1992 at the Royal Hospital for Sick Children, Glasgow were studied. There were 210 males and 150 females with a mean age of 60.7 months (0.5 to 198 months). Pilomatrixomata/sebaceous cysts (34 per cent), thyroglossal cysts (13 per cent), branchial remnants (nine per cent) and dermoids (nine per cent) accounted for almost twothirds of the 264 non-lymphadenomatous benign lesions excised. Ninety-three lymphadenopathy masses consisted of 60 with reactive hyperplasia, 21 with Mycobacterium infection and 12 lymphomas. There were three solid malignant tumours, two were rhabdomyosarcomata and one disseminated round cell tumour. The correlation between clinical diagnosis and histopathology of benign non-lymph node masses and solid tumours was 90 per cent and 100 per cent respectively, in benign lymph nodes, 66 per cent, but was poor in differentiating lymph node content. The mean time from presentation of a swelling to its excision was almost a year and the mean in-patient stay for excision of a mass was almost five days. The role of fine needle aspiration cytology (FNAC) in arriving at a diagnosis and reducing patient morbidity is discussed.

Keywords

Head and neck neoplasmsSurgeryPaediatricsHistologyBiopsy, needle
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 6 , June 1997 , pp. 541 - 545
Copyright
Copyright © JLO (1984) Limited 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barton, L. L., Feigin, R. D. (1974) Childhood cervical lymphadenitis. A reappraisal. Journal of Pediatrics 84: 846–852.CrossRefGoogle ScholarPubMed
Birchall, M. A., Stafford, N. D., Walsh-Waring, G. P. (1991) Malignant neck lumps: a measured approach. Annals of the Royal College of Surgeons of England 73: 91–95.Google ScholarPubMed
Bottles, K., Miller, T. R., Jeffrey, R. B., Cohen, M. B., Stoloff, A., Hales, M., Ljung, B. M., Donegan, E. (1986). Aspiration cytology characterisation of inflammatory masses. Western Journal of Medicine 144: 695–699.Google ScholarPubMed
Callender, D. L., Frankenthaler, R. A., Luna, M. A., Lee, S. S., Goepfert, H. (1992) Salivary gland neoplasms in children. Archives of Otolaryngology - Head and Neck Surgery 118: 472–476.CrossRefGoogle ScholarPubMed
Cohen, M. B., Bottles, K., Ablin, A. R., Miller, T. R. (1989) The use of fine needle aspiration biopsy in children. Western Journal of Medicine 150: 665–667.Google ScholarPubMed
Derias, N. W., Chong, W. H., Fitzgerald O'Connor, A. F. (1992) Fine needle aspiration cytology of head and neck swelling in a child: A non-invasive approach to diagnosis. Journal of Laryngology and Otology 106: 755–757.CrossRefGoogle Scholar
Eisele, D. W., Sherman, M. E., Koch, W. M., Richtsmeier, W. J., Wu, A. Y., Erozan, Y. S. (1992) Utility of immediate on-site cytopathological procurement and evaluation in fine needle aspiration biopsy of head and neck masses. Laryngoscope 102: 1328–1330.CrossRefGoogle ScholarPubMed
Fleisher, G., Grosflam, J., Selbst, S., Ludwig, S. (1984) Management of lymphadenitis in childhood: The role of percutaneous needle aspiration. Annals of Emergency Medicine 13: 908–911.CrossRefGoogle ScholarPubMed
Frable, W. J. (1976) Thin-needle aspiration biopsy. A personal experience with 469 cases. American Journal of Clinical Pathology 65: 168–182.CrossRefGoogle ScholarPubMed
Frable, M. A. S., Frable, W. J. (1982) Fine needle aspiration biopsy revisited. Laryngoscope 92: 1414–1416.CrossRefGoogle ScholarPubMed
Friedman, M., Kim, U., Shemaoka, K., Panahan, A., Stutzman, L. (1980) Appraisal of aspiration cytology in management of Hodgkin's disease. Cancer 45: 1653–1663.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Greenfield, S., Jordan, M. C. (1978) The clinical investigation of lymphadenopathy in primary care practice. Journal of the American Medical Association 240: 1388–1393.CrossRefGoogle ScholarPubMed
Kocjan, G. (1990) Evaluation of the cost effectiveness of establishing a fine needle aspiration cytology clinic in a hospital out-patient department. Cytopathology 2: 13–18.CrossRefGoogle Scholar
Kardos, T. F., Maygarden, S. J., Blumberg, A. K., Wakely, P. E. Jr., Frable, W. J. (1989) Fine needle aspiration biopsy in the management of children and young adults with peripheral lymphadenopathy. Cancer 63 (4): 703–707.3.0.CO;2-G>CrossRefGoogle Scholar
Knight, P. J., Mulne, A. F., Vassy, L. E. (1982) When is lymph node biopsy indicated in children with enlarged peripheral nodes? Pediatrics 69: 391–396.CrossRefGoogle ScholarPubMed
Lake, A. M., Oski, F. A. (1978) Peripheral lymphadenopathy in childhood. American Journal of Diseases of Children 132: 357.CrossRefGoogle ScholarPubMed
Lee, Y. N., Terry, R., Lukes, R. J. (1980) Lymph node biopsy for diagnosis: A statistical study. Journal of Surgical Oncology 14: 53–60.CrossRefGoogle ScholarPubMed
Lincoln, E. M., Gilbert, L. A. (1972) Disease in children due to mycobacteria other than Mycobacterium tuberculosis. American Review of Respiratory Disease 105: 683–714.Google ScholarPubMed
Liu, P., Daneman, A., Stringer, D. A., Ein, S. H. (1989) Percutaneous aspiration, drainage, and biopsy in children. Journal of Pediatric Surgery 24: 865–866.CrossRefGoogle ScholarPubMed
Meyers, A., Eiseman, B. (1990) Fine needle aspiration of head and neck mass. In Cost Effective Otolaryngology. (Lyles, A., Johns, M., eds.), Decker Inc., Philadelphia, Toronto, pp. 179–186.Google Scholar
Mobley, D. L., Wakely, P. E., Frable, M. A. S. (1991) Fine needle aspiration biopsy: Application to pediatric head and neck masses. Laryngoscope 101: 469–472.CrossRefGoogle ScholarPubMed
Obers, V. J., Phillips, J. I. (1991) Fine needle aspiration of pediatric abdominal masses. Ada Cytologica 35: 165–170.Google ScholarPubMed
Russ, J. E., Scanton, E. F., Christ, M. A. (1978) Aspiration cytology of head and neck masses. American Journal of Surgery 136: 342–347.CrossRefGoogle ScholarPubMed
Schaad, U. B., Votteler, T. P., McCracken, G. H., Nelson, J. D. (1979) Management of atypical mycobacterial lymphadenitis in childhood: A review on 380 cases. Journal of Pediatrics 95: 356–360.CrossRefGoogle ScholarPubMed
Schaller, R. T., Schaller, J. F., Buschmann, C., Kiviat, N. (1983) The usefulness of percutaneous fine-needle aspiration biopsy in infants and children. Journal of Pediatric Surgery 18: 398–405.CrossRefGoogle ScholarPubMed
Schelkun, P. M., Grundy, W. G. (1991) Fine-needle aspiration biopsy of head and neck lesions. Journal of Oral and Maxillofacial Surgery 49: 262–267.Google Scholar
Schulterover, S. J., Ramzy, I., Page, C. P., Lefebre, S. M., Cruz, A. B. (1984) Needle aspiration biopsy: role and limitations in surgical decision masking. American Journal of Clinical Pathology 82: 405–410.CrossRefGoogle Scholar
Silverman, J. F., Gurley, A. M., Holbrook, C. T., Joshi, V. V. (1991) Pediatric fine needle aspiration biopsy. American Journal of Clinical Pathology 95: 653–659.CrossRefGoogle ScholarPubMed
Slap, G. B., Connor, J. L., Wigton, R. S., Schwartz, J. S. (1986) Validation of a model to identify young patients for lymph node biopsy. Journal of the American Medical Association 255: 2768–2773.CrossRefGoogle Scholar
Stani, J. (1987) Cytologic diagnosis of reactive lymphadenopathy in fine needle aspiration biopsy specimens. Ada Cytologica 31: 8–13.Google ScholarPubMed
Tao, L. C., Pearson, F. G., Delarue, N. C., Langer, B., Sanders, D. E. (1980) Percutaneous fine-needle aspiration biopsy. Cancer 45: 1480–1485.Google Scholar
Taylor, S. R., Nuney, C. (1984) Fine-needle aspiration biopsy in a pediatric population. Cancer 54: 1449–1453.3.0.CO;2-#>CrossRefGoogle Scholar
Towbin, R. B., Strife, J. L. (1985) Percutaneous aspiration, drainage, and biopsies in children. Radiology 157: 81–85.CrossRefGoogle ScholarPubMed
Wakely, P. E. (1992) Merits of fine-needle aspiration biopsy in children: Head and neck. Diagnostic Cytopathology 8: 299–301.CrossRefGoogle ScholarPubMed
Wakely, P. E., Kardos, T. F., Frable, W. J. (1988) Application of fine needle aspiration biopsy of pediatrics. Human Pathology 19: 1383–1386.CrossRefGoogle Scholar
Young, J. E. M., Archibald, S. D., Shier, K. J. (1981) Needle aspiration cytologic biopsy in head and neck masses. American Journal of Surgery 142: 484–489.CrossRefGoogle ScholarPubMed
Zitelli, B. J. (1981) Neck masses in children: Adenopathy and malignant disease. Pediatric Clinics of North America 28: 81–821.CrossRefGoogle ScholarPubMed
Zueler, W. W., Kaplan, J. (1975) The child with lympadenopathy. Seminars in Hematology 12: 23–34.Google Scholar