Evidence map›Paper›PMID 40604578›Full record

ArticleBMC pediatrics2025

Reactive lymphoid hyperplasia mimicking acute appendicitis in children: a retrospective analysis of 259 cases.

Neslihan Gulcin, M Sddk Dicle, Cengiz Gul, Semih L Mirapoglu, Ceyhan Sahin, Mehmet Arpacık, Aytekin Kaymakcı

Erratum issuedAbstract read
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Article in BMC pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Neslihan Gulcin¹University of Health Sciences, Pediatric Surgery Department, Umraniye Training and Research Hospital, Istanbul, MD, Turkey. dr.neslii@hotmail.com.ORCID 0000-0003-3102-2838
M Sddk Dicle¹University of Health Sciences, Pediatric Surgery Department, Umraniye Training and Research Hospital, Istanbul, MD, Turkey.ORCID 0009-0001-2497-7508
Cengiz Gul¹University of Health Sciences, Pediatric Surgery Department, Umraniye Training and Research Hospital, Istanbul, MD, Turkey.ORCID 0000-0002-6164-9677
Semih L Mirapoglu¹University of Health Sciences, Pediatric Surgery Department, Umraniye Training and Research Hospital, Istanbul, MD, Turkey.ORCID 0000-0002-9100-583X
Ceyhan Sahin¹University of Health Sciences, Pediatric Surgery Department, Umraniye Training and Research Hospital, Istanbul, MD, Turkey.ORCID 0000-0003-3101-3915
Mehmet Arpacık¹University of Health Sciences, Pediatric Surgery Department, Umraniye Training and Research Hospital, Istanbul, MD, Turkey.ORCID 0000-0001-7149-5627
Aytekin Kaymakcı¹University of Health Sciences, Pediatric Surgery Department, Umraniye Training and Research Hospital, Istanbul, MD, Turkey.ORCID 0000-0002-6147-5566

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis 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.

methodsA 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.

resultsAmong 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.

conclusionsRLH 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 registrationClinical trial number: Not applicable.

Indexed as

AppendicitisPseudolymphomaAcute DiseaseAdolescentAppendectomyChildChild, PreschoolDiagnosis, DifferentialFemaleHumansLaparoscopyMaleRetrospective StudiesUltrasonographyAbdominal painAcute appendicitisHistopathologyNegative appendectomyPediatric surgeryReactive lymphoid hyperplasia

Identifiers

PMID40604578
PMCPMC12220679

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.