Case Report: Pediatric nasopharyngeal carcinoma masquerading as benign lymphadenopathy: diagnostic pitfalls in two cases
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By
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Yuhan Qiu
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Yan Cheng
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Aiqin Lin
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Hui Li
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Jie Liu
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Wei Zhang
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June 16, 2026
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Clinical Scorecard: Pediatric Nasopharyngeal Carcinoma Presenting as Benign Lymphadenopathy: A Report on Diagnostic Challenges in Two Cases
At a Glance
| Category | Detail |
|---|
| Condition | |
| Key Mechanisms | Malignant tumor arising from nasopharyngeal epithelium, often associated with Epstein–Barr virus (EBV) infection. |
| Target Population | |
| Care Setting | |
Key Highlights
- NPC is rare in children, accounting for <1% of pediatric malignancies.
- Initial misdiagnosis can occur as benign conditions like Kimura disease or Hodgkin lymphoma.
- Persistent cervical lymphadenopathy in children should prompt early biopsy and ancillary studies.
- Immunohistochemistry is crucial for accurate diagnosis of NPC.
Guideline-Based Recommendations
Diagnosis
- Consider core or excisional biopsy for persistent cervical lymphadenopathy.
- Utilize cytokeratin staining and EBER in-situ hybridization for diagnosis.
Management
- Multimodal chemoradiotherapy is recommended for treatment.
Monitoring & Follow-up
- Regular follow-up is essential post-treatment.
Risks
- Delayed diagnosis due to mimicry of benign conditions.
Patient & Prescribing Data
Pediatric patients with cervical lymphadenopathy.
Clinical Best Practices
- Maintain a high index of suspicion for NPC in children with unexplained cervical lymphadenopathy.
- Perform comprehensive immunohistochemical analysis on biopsies.
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