20: Masses And LAD In Children

Question 1

Definition of LAD

Answer 1

LNs that are abnormal in size, number, or consistency

Question 2

Two broad reasons for LAD

Answer 2

1. Proliferation of normal cells (in infection)

2. Infiltration of LN by foreign or abnormal cells (malignancy)

Question 3

Most important part of a workup for a child with LAD

Answer 3

History and physical

Question 4

Ten worrisome findings in a child with LAD

Answer 4

1. B symtpoms
2. Supraclavicular nodes
3. Generalized LAD
4. Fixed, enlarged, non-tender nodes
5. Rapidly enlarging LNs
6. Tenderness, warmth, redness
7. Respiratory sx
8. Abnormal mediastinal area on CXR
9. Persistent LAD >4 weeks
10. LAD with enlarged spleen and/or liver

Question 5

Indications for pt with LAD who is systemically well vs systemically ill

Answer 5

1. Well: watch, try Abx, if they dont go away after 4-6wks do a biopsy
2. Ill: work up with lab and imaging (CXR), likely will need biopsy if anything suspicious

Question 6

Sturge Weber syndrome: 3 hallmarks

Answer 6

Facial port wine stain + leptomeningeal angiomas + developmental delay

Question 7

What to do if a baby’s hemangioma grows a deep dimple over the lumbosacral area

Answer 7

MRI/US to check for spinal cord abnormality

Question 8

Five most common sites of origin for malignant pediatric cancers

Answer 8

1. Hematopoeitic system
2. Nervous tissue
3. Soft tissue
4. Bone
5. Kidneys

Question 9

Most common malignancies for kids under ten vs 15-19 years old

Answer 9

1. Under 10: Leukemia

2. 15-19: Hodgkin lymphoma