Çocukluk çağı Hodgkin dışı lenfomalarında tanısal özellikler
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Date
2009
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Uludağ Üniversitesi
Abstract
Giriş: Bu çalışmanın amacı merkezimizde tedavi edilen 18 yaşından küçük Hodgkin dışı lenfomalı (HDL) hastaların ilk başvurudaki özelliklerini tanımlayarak tanısal önemi olan verileri belirlemektir. Gereç ve Yöntem: HDL tanısı alan çocukların kayıtları retrospektif olarak değerlendirildi. Yaş ve cinsiyet, tümör yerleşimi, ilk başvuru yakınmaları, semptomların süresi, histopatolojik alt grubu, hastalığın evresi ve bazı laboratuvar değerleri kaydedildi. Bulgular: HDL tanısı alan 118 hastada ortalama yaş 8,2±3,9 yıl (median 8,6 yıl) bulundu. Çocukların %31,3’ü beş yaşından küçük ve %12,7’si ilk üç yaşta idi. Erkek/kız oranı 4,3 idi. Hastalığın evresi olguların %4,2’sinde evre 2, %78’inde evre 3 ve %17,8’inde evre 4 olarak belirlendi. HDL’li çocukların %39’unda abdominal kitle ve %24,6’sında mediastinal kitle mevcuttu. Periferik lenf düğümlerinden başlayan HDL %14,4; nazofarenks, Waldeyer halkası ve tonsillerde yerleşim %11,9; orbita, paranazal sinüsler ve yüz kemiklerinde yerleşim ise %5,1 bulundu. Diğer tümörler paravertebral bölgede ve santral sinir sisteminde yerleşmekte idi (%5,1). Yakınmaların süresi iki gün ile 52 hafta arasında değişmekte olup, ortalama süre 6,3±7,8 hafta bulundu. HDL’li çocuklarda en sık yakınma lenfadenopati ve ailenin farkedebildiği şişlik veya kitle bulunması idi (%57). Hastaların %40’ında karın şişliği, %33’ünde nefes darlığı ve %29’unda öksürük yakınması vardı. Ateş, kilo kaybı, iştahsızlık ve halsizlik gibi genel belirtiler ortalama %43 olguda mevcuttu. HDL tanısında tümör yükünü gösteren LDH yüksekliği hastaların %60’ında gözlendi. Sonuç: Çocuklarda HDL’lerin sıklığı, klinik ve histopatolojik özellikleri bölgesel farklılıklar gösterir. Veriler merkezimize gelen hastaların %95,8’inin ileri evrede tanı aldığını ve beş yaşından önce abdominal, büyük çocuklarda ise mediastinal ve nodal hastalık bulgularının fazla olduğunu göstermektedir. Olguların %85’inde iki aydan kısa süren yakınmalar mevcuttur.
Introduction: The aim of this study is to evaluate admissonal clinical and laboratory characteristics of pediatric non-Hodgkin lymphoma (NHL) patients who are treated in our department. Materials and Method: Data of pediatric NHL patients were reviewed retrospectively. Age, sex, history of disease, histopathological classification, localization of mass, stage, and a number of laboratory tests were recorded. Results: One hundred eighteen NHL patients were included. The mean age of the patients was 8.2±3.9 (median 8.6) years. While the patients under 5 years constituted 31.3% of all, the ratio of patients under 3 years was 12.7%. Male to female ratio was 4.3. The evaluation according to the stages of the disease showed that 4.2% of patients were stage II, 78% were stage III and 17.8% were stage IV. Thirty nine percent of patients presented with abdominal mass and 24.6% were with mediastinal mass. Primary peripheral lymph node originated disease was seen in 14.4%; nasopharynx, Waldeyer ring and tonsils were involved in 11.9% and paranasal sinuses and facial bones in 5.1%. The rest was localized in paravertebral region and central nervous system (5.1%). The symptomatic period before admission was ranged between 2 days and 52 weeks (mean 6.3±7.8 weeks). The most common symptom was swelling due to underlying lymphadenopathies or mass (57%). Forty percent of patients presented with abdominal distension, 33% with dyspnea, and 29% with cough. Systemic symptoms like fever, weight loss and malaise were found in 43% of patients. High lactate dehydrogenase (LDH) levels were found in 60% of patients. Conclusion: Incidence, clinical and histopathological features of childhood NHL show regional differences. Our results revealed that 95.8% of patients had advanced stage disease, the patients under five years mostly presented with abdominal mass and the older children with mediastinal and nodal involvement. The history lasted less than two months in 85% of patients.
Introduction: The aim of this study is to evaluate admissonal clinical and laboratory characteristics of pediatric non-Hodgkin lymphoma (NHL) patients who are treated in our department. Materials and Method: Data of pediatric NHL patients were reviewed retrospectively. Age, sex, history of disease, histopathological classification, localization of mass, stage, and a number of laboratory tests were recorded. Results: One hundred eighteen NHL patients were included. The mean age of the patients was 8.2±3.9 (median 8.6) years. While the patients under 5 years constituted 31.3% of all, the ratio of patients under 3 years was 12.7%. Male to female ratio was 4.3. The evaluation according to the stages of the disease showed that 4.2% of patients were stage II, 78% were stage III and 17.8% were stage IV. Thirty nine percent of patients presented with abdominal mass and 24.6% were with mediastinal mass. Primary peripheral lymph node originated disease was seen in 14.4%; nasopharynx, Waldeyer ring and tonsils were involved in 11.9% and paranasal sinuses and facial bones in 5.1%. The rest was localized in paravertebral region and central nervous system (5.1%). The symptomatic period before admission was ranged between 2 days and 52 weeks (mean 6.3±7.8 weeks). The most common symptom was swelling due to underlying lymphadenopathies or mass (57%). Forty percent of patients presented with abdominal distension, 33% with dyspnea, and 29% with cough. Systemic symptoms like fever, weight loss and malaise were found in 43% of patients. High lactate dehydrogenase (LDH) levels were found in 60% of patients. Conclusion: Incidence, clinical and histopathological features of childhood NHL show regional differences. Our results revealed that 95.8% of patients had advanced stage disease, the patients under five years mostly presented with abdominal mass and the older children with mediastinal and nodal involvement. The history lasted less than two months in 85% of patients.
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Keywords
Lenfoma, Çocukluk çağı, Laktik dehidrogenaz, Lymphoma, Childhood, Lactate dehydrogenase
Citation
Sevinir, B. ve Demirkaya, M. (2009). "Çocukluk çağı Hodgkin dışı lenfomalarında tanısal özellikler". Güncel Pediatri, 7(3), 111-116.