Étude Histopathologique des Adénopathies Superficielles chez l’Enfant à Libreville

I RESUME Introduction. Les adenopathies (ADP) constituent un motif frequent de consultation en pediatrie. Le but de l’etude etait de decrire les differents aspects anatomopathologiques des ADP superficielles chez l’enfant et l’adolescent a Libreville. Methodes. Etude retrospective ayant eu lieu dans les laboratoires d’anatomo-pathologie de l’Universite des Sciences de la Sante et de l’Hopital d’Instructions des Armees Omar Bongo Ondimba. Elle a collige 251 cas de pieces de biopsie exerese d’ADP superficielle realisee entre janvier 1994 et decembre 2015. Les parametres etudies etaient : âge, sexe, taille de l’ADP, siege de l’ADP, et le diagnostic histologique. Resultats. L’âge moyen etait de 10±4,87 ans avec un sex-ratio de 1,22. La tranche d’âge 11-17 ans etait la plus observee (51,8%). La taille moyenne des ADP etait de 2,37 cm. La localisation cervicale representait 79,7% de cas. L’adenite tuberculeuse etait l’etiologie la plus observee (51%), suivie de l’hyperplasie folliculaire et sinusale (20,3%) et du lymphome malin non hodgkinien (13,9%). L’adenite tuberculeuses et le lymphome malin non hodgkinien etaient plus observes dans la tranche d’âge 11-17 ans. Nous n’avons pas observe de difference significative entre l’âge et le caractere benin-malin (p=0,34), entre le sexe et le caractere benin-malin (p=0,9), ni entre la localisation et la malignite (p=0,38). Les ADP superieures a un centimetre representaient 87,7% des ADP malignes contre 83% des ADP benignes (p<0,001). Conclusion. L’etiologie des ADP superficielles chez l’enfant est dominee par les causes benignes notamment infectieuses, mais la realisation d’une analyse anatomopathologique de toute ADP suspecte est recommandee. ABSTRACT Introduction. Lymphadenopathy is a common reason for consultation in children. The purpose of the study was to describe the histopathology of the superficial lymph nodes in children and adolescents in Libreville. Methods. This was a retrospective study which took place in the Pathology Laboratory of the University of Health Sciences and the Omar Bongo Ondimba Military Hospital’s Pathology Laboratory. We collected 251 cases of biopsy of superficial nodes performed between January 1994 and December 2015. The studied parameters were: age, sex, size of the nodes, localization of the nodes, and the histological diagnosis. Results. The mean age was 10 ± 4.9 sex ratio was 1.22. The 11-17 age group was the most observed (51.8%). The average size of the lymphadenopathy was 2.37 cm. Cervical localization represented 79.7% of cases. Caseous lymphadenitis was the most observed etiology (51%), followed by the sinusal and follicular hyperplasia (20.3%) and non-Hodgkin’s lymphoma (13.9%). Caseous lymphadenitis and non Hodgkin lymphoma were most common in the 11-17 years old age group. There was no statistically significant difference in age for benign vs. malignant condition (p=0.34), for sex in character benign-malignant condition (p=0.9), nor between localization and malignancy (p = 0.38). Nodes bigger than one centimeter represented 87.7% of the malignant lymphadenopathy, versus 83% of benign lymphadenopathy (p < 0.001). Conclusion. The etiology of the superficial lymphadenopathy in children is led by benign, namely infectious causes, but the pathological analysis of any suspect node is recommended.