Reactive lymphoid hyperplasia mimicking acute appendicitis in children: a retrospective analysis of 259 cases
Abstract Purpose This study aimed to evaluate and compare the clinical, laboratory, imaging, and histopathological findings of pediatric patients diagnosed with reactive lymphoid hyperplasia (RLH) among those who underwent surgery with a pre-diagnosis of acute appendicitis. Methods A retrospective a...
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BMC
2025-07-01
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| Series: | BMC Pediatrics |
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| Online Access: | https://doi.org/10.1186/s12887-025-05870-8 |
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| author | Neslihan Gulcin M. Sddk Dicle Cengiz Gul Semih L. Mirapoglu Ceyhan Sahin Mehmet Arpack Aytekin Kaymakc |
| author_facet | Neslihan Gulcin M. Sddk Dicle Cengiz Gul Semih L. Mirapoglu Ceyhan Sahin Mehmet Arpack Aytekin Kaymakc |
| author_sort | Neslihan Gulcin |
| collection | DOAJ |
| description | Abstract Purpose This study aimed to evaluate and compare the clinical, laboratory, imaging, and histopathological findings of pediatric patients diagnosed with reactive lymphoid hyperplasia (RLH) among those who underwent surgery with a pre-diagnosis of acute appendicitis. Methods A retrospective analysis was conducted on 3,469 pediatric patients who underwent appendectomy between January 2013 and January 2025. A total of 259 patients with histopathologically confirmed RLH were included in the study. Their clinical presentations, laboratory parameters, imaging findings, and surgical notes were analyzed. Where possible, comparisons were made with the remaining cohort. Results Among the RLH cases, 61% were male, with a mean age of 11.6 ± 4.2 years. Inflammatory markers such as WBC and CRP were elevated in only a subset of patients. Although ultrasonographic findings frequently mimicked acute appendicitis, histopathological evaluation revealed no signs of true inflammation. Laparoscopic appendectomy was performed in 77.2% of RLH patients, and all were discharged without complications. During follow-up, some patients developed systemic or autoinflammatory conditions such as FMF, IBD, or celiac disease. Comparative analysis showed that such conditions were significantly more common in the RLH group than in the non-RLH cohort. Conclusions RLH is a benign condition that may clinically and radiologically mimic acute appendicitis. In stable pediatric patients with low inflammatory markers, conservative management should be considered to avoid unnecessary surgical interventions. Preoperative identification remains challenging, highlighting the importance of a multidisciplinary diagnostic approach. This study, with one of the largest cohorts to date, provides new insights into the natural history and diagnostic pitfalls of RLH. Clinical trial registration Clinical trial number: Not applicable. |
| format | Article |
| id | doaj-art-42799dba1d034c31bd81fe21b83b02a3 |
| institution | Kabale University |
| issn | 1471-2431 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj-art-42799dba1d034c31bd81fe21b83b02a32025-08-20T04:01:36ZengBMCBMC Pediatrics1471-24312025-07-012511610.1186/s12887-025-05870-8Reactive lymphoid hyperplasia mimicking acute appendicitis in children: a retrospective analysis of 259 casesNeslihan Gulcin0M. Sddk Dicle1Cengiz Gul2Semih L. Mirapoglu3Ceyhan Sahin4Mehmet Arpack5Aytekin Kaymakc6¹University of Health Sciences, Pediatric Surgery Department, Umraniye Training and Research Hospital¹University of Health Sciences, Pediatric Surgery Department, Umraniye Training and Research Hospital¹University of Health Sciences, Pediatric Surgery Department, Umraniye Training and Research Hospital¹University of Health Sciences, Pediatric Surgery Department, Umraniye Training and Research Hospital¹University of Health Sciences, Pediatric Surgery Department, Umraniye Training and Research Hospital¹University of Health Sciences, Pediatric Surgery Department, Umraniye Training and Research Hospital¹University of Health Sciences, Pediatric Surgery Department, Umraniye Training and Research HospitalAbstract Purpose This study aimed to evaluate and compare the clinical, laboratory, imaging, and histopathological findings of pediatric patients diagnosed with reactive lymphoid hyperplasia (RLH) among those who underwent surgery with a pre-diagnosis of acute appendicitis. Methods A retrospective analysis was conducted on 3,469 pediatric patients who underwent appendectomy between January 2013 and January 2025. A total of 259 patients with histopathologically confirmed RLH were included in the study. Their clinical presentations, laboratory parameters, imaging findings, and surgical notes were analyzed. Where possible, comparisons were made with the remaining cohort. Results Among the RLH cases, 61% were male, with a mean age of 11.6 ± 4.2 years. Inflammatory markers such as WBC and CRP were elevated in only a subset of patients. Although ultrasonographic findings frequently mimicked acute appendicitis, histopathological evaluation revealed no signs of true inflammation. Laparoscopic appendectomy was performed in 77.2% of RLH patients, and all were discharged without complications. During follow-up, some patients developed systemic or autoinflammatory conditions such as FMF, IBD, or celiac disease. Comparative analysis showed that such conditions were significantly more common in the RLH group than in the non-RLH cohort. Conclusions RLH is a benign condition that may clinically and radiologically mimic acute appendicitis. In stable pediatric patients with low inflammatory markers, conservative management should be considered to avoid unnecessary surgical interventions. Preoperative identification remains challenging, highlighting the importance of a multidisciplinary diagnostic approach. This study, with one of the largest cohorts to date, provides new insights into the natural history and diagnostic pitfalls of RLH. Clinical trial registration Clinical trial number: Not applicable.https://doi.org/10.1186/s12887-025-05870-8Reactive lymphoid hyperplasiaAcute appendicitisPediatric surgeryNegative appendectomyAbdominal painHistopathology |
| spellingShingle | Neslihan Gulcin M. Sddk Dicle Cengiz Gul Semih L. Mirapoglu Ceyhan Sahin Mehmet Arpack Aytekin Kaymakc Reactive lymphoid hyperplasia mimicking acute appendicitis in children: a retrospective analysis of 259 cases BMC Pediatrics Reactive lymphoid hyperplasia Acute appendicitis Pediatric surgery Negative appendectomy Abdominal pain Histopathology |
| title | Reactive lymphoid hyperplasia mimicking acute appendicitis in children: a retrospective analysis of 259 cases |
| title_full | Reactive lymphoid hyperplasia mimicking acute appendicitis in children: a retrospective analysis of 259 cases |
| title_fullStr | Reactive lymphoid hyperplasia mimicking acute appendicitis in children: a retrospective analysis of 259 cases |
| title_full_unstemmed | Reactive lymphoid hyperplasia mimicking acute appendicitis in children: a retrospective analysis of 259 cases |
| title_short | Reactive lymphoid hyperplasia mimicking acute appendicitis in children: a retrospective analysis of 259 cases |
| title_sort | reactive lymphoid hyperplasia mimicking acute appendicitis in children a retrospective analysis of 259 cases |
| topic | Reactive lymphoid hyperplasia Acute appendicitis Pediatric surgery Negative appendectomy Abdominal pain Histopathology |
| url | https://doi.org/10.1186/s12887-025-05870-8 |
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