الفهرس 
Introduction
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Abstract
This work has included 79 children presenting with lymphadenopathy of different aetiologies (58 males and 21 females and mean age 5.8 3.5 years). They were presented to the Outpatient Clinics of Mansoura University Children Hospital. Diagnosis was made on the basis of histopatholagic analysis of lymph node or bone marrow biopsy samples. Flowcytometric cell cycles and apoptosis % analysis was carried out for samples taken from in the lymph node by fine needle aspiration from 46 cases and peripheral blood samples from 50 cases. DNA cycle analysis as well as apoptosis % were correlated to the histopathologic diagnosis of lymphnode and bone marrow samples. Furthermore, these data were also correlated with clinical phenotype, and hematologic investigations. Of the 79 studied total cases, diagnosis of leukemia was the commonest cause of lymphadenopathy followed by inflammatory adenitis We have observed that the commonest age of affection is the 26 years. Signs of infection were present mainly in cases of adenitis, we observed that no difference between malignant and benign nodes was found regarding the S phase %, while the G0/1 and G2/Mpeaks showed a significant difference. On the other hand, in peripheral blood lymphocyte samples, the G0/1 and G2/M peak values as well as the S phase fraction were significantly different between malignant and benign cases. CV of G1peak (at a level around 3.5%) was significantly higher in malignant nodes. Apoptosis % in our cases showed higher values among adenitis group. We have found about one third of our lymph node aspiration samples showing aneuploidy while it was present among about half of peripheral blood samples. Parameters showing good sensitivity (true positive rate) for malignant diagnosis were DNA index, G2/M peak, G0/1 and apoptosis % in peripheral blood lymphocyte samples. The positive predictive values (probability of the positive to be true positive) were higher using parameters including G0/1, G2/M, apoptosis % and DNA index of peripheral blood samples. Negative to be true negative) were evident for lymph node samples CV% and apoptosis %. And DNA ploidy may serve as an additional parameter in problematic histological dignity assessments of soft tissue tumors. Immediate follow up of malignant cases after induction therapy have shown that some cases entered into remmision phase, while the others showed resistance to remmision or died during induction. Also, better rate of remmision was obtained in aneuploid cases than diploid ones. According to present analysis, prediction of malignancy can be suggested through a discriminant score depending on G2/M value of lymph node aspiration sample and coded value for CBC. Therefore, we conclude that : Using DNA cycle analysis and apoptosis % in addition to routine immunephenotyping of peripheral blood lymphocytes and lymph node aspiration samples can be of help for differentiating malignant from benign cases as well as prediction of prognosis.