CIS: Pediatric Lymphadenitis/Lymphadenopathy Flashcards
where is lymph not existent?
the brain and the heart
How will this usually present?
parent will come in worried about a lump that recently appeared on the child
Where are lymph nodes worriesome?
Cervical
supraclavicular
axillary
inguinal
Which place for lymph nodes is really not common and we should worry about?
supra-clavicular!!!
What are the three other common lymph node spots?
Cervical
axiallary
inguinal
What do we examine if we find an enlarged lymph node?
- just examine where that node drains from
- right inguinal, right leg
- suboccipital, check the scalp
What size of the lymph node is considered enlarged?
> 2cm
What location of nodes is NOT normal?
supraclavicular
are palpable lymph nodes are usual in nerwborn babies?
nope
shotty nodes, what are they common with?
early childhood with viral illness
How common is reactive cervical LAD?
VERY COMMON
-in preschool/early school age
What do we think of if we see generalized LAD in 2 or more nodal groups?
HIV
What do we do for the Plan?
- not shotgun approach
- watchful waiting
- finish this…
What was the important lab work that we do if the etiology of the LAD is unclear?
LDH
-lactate dehydrogenase, a marker for hematologic malignancies
When do we biopsy?
- if watchful waiting but the nodes never get better
- if the abx don’t work
- right away if an enlarged supraclavicular node
What kind of infection is associated with and isolated enlarged lymph nodes?
bacterial is more common
parinaud’s syndrome
- conjunctivitis
- preauricular adenitis
- conjunctival granuloma
Painless testicular mass w/o hx of injury, what do we do?
a chest Xray!
Taratomas
- shows up in the anterior mediastium
- sacrococcygeal are the most common
- they are crazy looking
Neuroblastoma
- <10 y/o
- tumors of the symp ganglia and adrenal medulla
- derived from primordial neural crest cells wich populate these sites
- most common extracranial solid tumor of childhood
- produce catecholamines*****
- BLUEBERRY BABIES!!!
Wilm’s Tumor
- most common primary renal tumor of childhood
- <10 y/o
- WAGR syndrome: Wilms tumor, aniridia, genital anomalies, mental retardation
- del 11p13
- Denys-Drash syndrome: gondal dysgenesis, 90% chance of developing wilms tumor
Define lymphadenopathy
lymph nodes that are abnormal in
- size
- number
- consistency
What location of lymph nodes should worry us?
supra-clavicular
What is the most important component of the workup for LAD?
History and physical
What size of lymph nodes is considered enlarged?
> 2cm
where is the weird location again?
supraclavicular
-HIV
When do we biopsy a lymph node?
- if it isn’t getting better
- if abx aren’t making it any better
- right away if supraclavicular
What was the sign of Cat scratch disease that had an asterix next to it?
Neuroretinits
If there is a testicular mass, especially painless without hx of trauma/injury, what is indicated?
a chest radiograph!
What is a marker for most hematologic entities?
LDH
How will a Wilms tumor present?
- large abdominal mass
- hematuria
- pain int he abdomen after some traumatic incident
- intestinal obstruction
- hypertension
- pulmonary metastases are often present at diagnosis
