Evaluation of lymphadenopathy in children

Lymphadenopathy, the presence of abnormal lymph nodes, is a common finding in paediatric practice. This may be the sole presenting feature or one of a constellation of symptoms and signs. The underlying aetiological causes are numerous and diverse, but can broadly be considered to be reactive, infective or malignant in nature. Investigation of these children ranges from observation to detailed radiological imaging and biopsy and is led by pertinent history taking and examination. Significant anxiety can surround the finding of lymphadenopathy in children in both parents and health professionals due to concern regarding sinister underlying pathology. A structured clinical approach to these children utilizing appropriate background knowledge and the multidisciplinary team facilitates diagnosis and guides management. This review aims to provide a useful clinical guide for paediatric trainees to assist in the assessment and management of such children.