Cervical Adenopathy in Children: A Rational use of Investigations/Resources

Abstract

It is not unusual to see a child with enlarged neck nodes and such nodes are very common in otherwise normal children. While the majority are benign and self-limiting (in acute enlargement) there is often a lingering concern that this a symptom of an underlying serious condition and that referral, investigation and perhaps biopsy or FNAC (fine needle aspiration cytology) are warranted. This is especially the case when parental anxiety cannot be assuaged or there is worry over litigation. This paper aims to present a rational management plan for a child with cervical adenopathy and to suggest guidelines as to when to observe, when to investigate and or to refer such patients. It is useful to have a systematic and structured approach to this common problem, not only to provide diagnostic accuracy but also to recognize certain red flags that should prompt investigation, treatment and referral. In so doing this paper hopes
to encourage rational use of resources in this clinical setting.