Patrones histopatológicos asociados a linfadenopatías reactivas de etiología no neoplásica en niños: revisión bibliográfica
Histopathological patterns associated with reactive lymphadenopathies of non-neoplastic etiology in children: bibliographic review

Carlos Daniel Cárdenas Santos, Miguel José Gandica Chacón, Ziulmar Joaquina Mejías Gómez, David Leandro Delgado Chacón, Delsa Dayanna Delgado

Resumen


RESUMEN
Introducción: las linfadenopatías reactivas son el agrandamiento de los ganglios linfáticos como consecuencia de la respuesta inmune del cuerpo, una condición frecuente en pediatría. Objetivo: caracterizar las linfadenopatías reactivas de etiología no neoplásica según sus patrones histopatológicos. Metodología: se realizó una revisión bibliográfica desde enero de 2010 hasta enero de 2025; se utilizaron bases de datos como PubMed, Science Direct, Scielo, Bvsalud y Google Académico. Una vez identificados los artículos y eliminados los duplicados, se realizó un proceso de (pre) selección, elección y análisis, siguiendo la normativa PRISMA. Tomando los criterios de inclusión y exclusión. Resultados: un total de 33 artículos fueron revisados. Las linfadenopatías reactivas se clasifican por etiología y patrones histopatológicos, que incluyen: hiperplasia folicular (área de células B), expansión interfolicular o parafolicular (área de células T), histiocitosis sinusal (áreas de monocitos y macrófagos), linfadenitis granulomatosa y necrosante (supurativa), y un patrón mixto que combina algunos o todos los patrones anteriores. Conclusiones: el agrandamiento ganglionar en niños es común y abarca diversas etiologías, siendo pocos los casos que requieren biopsia. Las linfadenopatías reactivas exigen una evaluación integral, estudios complementarios y análisis histopatológico para identificar patrones reactivos específicos, facilitando el diagnóstico diferencial de procesos reactivos benignos de aquellos que son malignos o que simulan estos últimos, optimizando así el manejo clínico. Esta revisión busca guiar el estudio de estas patologías en pediatría, destacando la importancia de la actualización continua y ofreciendo una síntesis clara que unifique las linfadenopatías reactivas no neoplásicas basado en sus patrones histopatológicos.

ABSTRACT
Introduction: Reactive lymphadenopathies are the enlargement of lymph nodes as a consequence of the body's immune response, a frequent condition in pediatrics. Objective: To characterize reactive lymphadenopathies of non-neoplastic etiology according to their histopathologic patterns. Methodology: A literature review was performed from January 2010 to January 2025; databases such as PubMed, Science Direct, Scielo, Bvsalud and Google Scholar were used. Once the articles had been identified and duplicates eliminated, a process of (pre)selection, selection and analysis was carried out, following the PRISMA guidelines. Inclusion and exclusion criteria were used. Results: A total of 33 articles were reviewed. Reactive lymphadenopathies are classified by etiology and histopathological patterns, which include: follicular hyperplasia (B-cell area), interfollicular or parafollicular expansion (T-cell area), sinus histiocytosis (areas of monocytes and macrophages), granulomatous and necrotizing (suppurative) lymphadenitis, and a mixed pattern combining some or all of the above patterns. Conclusions: lymph node enlargement in children is common and involves various etiologies, with few cases requiring biopsy. Reactive lymphadenopathies require a comprehensive evaluation, complementary studies and histopathological analysis to identify specific reactive patterns, facilitating the differential diagnosis of benign reactive processes from those that are malignant or that simulate the latter, thus optimizing clinical management. This review seeks to guide the study of these pathologies in pediatrics, highlighting the importance of continuous updating and offering a clear synthesis that unifies non-neoplastic reactive lymphadenopathies based on their histopathologic patterns.

Recibido: 18-05-2025
Aceptado: 28-06-2025
Publicado: 04-07-2025


Palabras clave


linfadenopatia; reactiva; linfadenitis; ganglio linfático; niños; lymphadenopathy; reactive; lymphadenitis; lymph nodeM children

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Referencias


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