AN IN-DEPTH CLINICAL AND PATHOLOGICAL ANALYSIS OF NECK MASSES IN THE PAEDIATRIC AGE GROUP
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Keywords
Clinicopathological correlation; Congenital neck lesions; Fine needle aspiration cytology; Lymphangioma; Non-infective Paediatric neck masses
Abstract
Non-infective Paediatric neck masses constitute a wide array of conditions, ranging from benign congenital anomalies to malignancy. Early and correct diagnosis is crucial to avoid complications & delayed interventions. This 30-month prospective observational study was undertaken among 42 paediatric patients with neck swellings presenting to a tertiary care centre. Each patient was subjected to careful clinical evaluation, imaging such as ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI) as indicated, and fine needle aspiration cytology (FNAC). Histopathological examination was done in cases as required for confirmation of diagnosis. The patients were followed up at two, six, and twelve months for assessment of results and recurrence. The estimated incidence of Non-infective paediatric neck masses was one in 1,553 paediatric ENT cases. The most common were congenital lesions, representing 59.5 percent of the cases, with the most common being lymphangiomas. Malignancies represented 23.8 percent, which were mostly non-Hodgkin lymphoma. FNAC was 96.2 percent sensitive and 79.4 percent concordant with histopathology. Surgical intervention was the most frequent treatment modality, applied to 57 percent of cases, followed by chemotherapy and medical therapy. Two recurrences were reported in lymphangiomas, and minor complications occurred in both the surgery and chemotherapy groups. A combination of clinical, radiological, and cytological findings based on anatomy can enhance early diagnosis and targeted treatment of paediatric masses of the neck. Location of the lesion is a useful malignancy predictor. Multicentre studies with uniform diagnostic protocols and longer follow-up are necessary to confirm these observations.
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Dr. Satish Bhong
ENT Surgeon, Noble Hospitals & Research Centre, Hadapsar, Pune.
Dr Pravin Bhosale
ENT surgeon, Sahyadri Hospital, Hadapsar, Pune
Dr. Vijay Sharma
ENT surgeon, manipal hospital, kharadi, Pune
Dr. Vikram Chavan
Radiologist, Konaseema medical College, Amlapuram, Andra Pradesh