• Correlation of ultrasound and pathomorphological changes in bacterial lymphadenitis in children

Correlation of ultrasound and pathomorphological changes in bacterial lymphadenitis in children

SOVREMENNAYA PEDIATRIYA.2018.3(91):48-53; doi 10.15574/SP.2018.91.48

Talko M. O.
Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine

Objective: to analyse the results of ultrasonic evaluation with cytomorphological changes in bacterial lymphadenitis in children, depending on the stage of inflammation and its nature.

Material and methods. In total 23 ultrasonic and cytomorphological reports of paediatric patients who underwent treatment for acute bacterial lymphadenitis in our clinic between 2013 and 2018 were evaluated. The ultrasound was performed using the LogiQ 5 device with a linear 7.5 MHz sensor. Excisional biopsy was performed. Histological examination was carried out according to the standard protocols, using light microscopy with 200–400 magnifications.

Results. In 23 analysed samples of lymph nodes, granulomatous-necrotic inflammation was found predominantly as pathological result (in 18 cases that made up 78.2%). The most common ultrasonic manifestations were significant increase in size with a tendency towards rounding. Parenchyma presented by pronounced heterogeneity, due to the alternation of hypo- and anechoic areas. In some cases, with the BCG-associated lymphadenitis, small hyperechoic inclusions have been identified, which were represented by the sites of calcification in the histologic specimens. Using the colour flow mapping, a pronounced reduction or absence of intranodular blood flow with its increase in the adjacent tissues with purulent inflammation was revealed. The abovementioned ultrasound data was also noted in non-specific lymphadenitis in the stage of serous inflammation with signs of initial abscessing, which was confirmed histologically by the presence of sites of micro-abscessing.

Conclusions. Comparison of ultrasound data in bacterial lymphadenitis with the results of histologic examination revealed connection between ultrasonic structure and pathomorphological signs, depending on the stage of inflammation and its nature.

Key words: lymphadenitis, ultrasound, biopsy.

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