Masses and Lymphadenopathy Flashcards
What is lymphadenopathy (LAD)?
Lymph nodes that are abnormal in size, number, or consistency
What is the most important part of the work-up for a child with lymphadenopathy?
History and physical
What LN location should you be wary of if there is enlargement?
Supraclavicular
What LN qualities are reassuring?
1) Soft
2) Mobile
3) Non tender
4) Not warm/red
What LN qualites are more concerning?
1) Very large
2) Fixed location
3) Tender
4) Erythematous and warm
Enlargement of what organs may be indicative of a malignancy or systemic infection?
Liver/spleen
Cervical lymphadenopathy is one of the diagnostic criteria of what disease?
Kawasaki disease
What viral infection causes mononucleosis (severe pharyngitis, cervical LAD, spleen enlargement)?
Epstein-Barr virus
What viral infection in a child will cause wasting and has diffuse lymphadenopathy?
HIV
Bartonella henselae (Cat-scratch disease) causes what type of LAD?
What is seen on exam of the retina?
1) Axillary LAD
2) Macular star
What bacterial infection is associated with skinning rabbits?
Tularemia
What is a super common cause of bacterial lymphadenitis, and with these conditions you want to look for lesion on skin in region of body that drains into the enlarged node?
Staph/strep
What should be performed with any child presenting with lymphadenopathy and shortness-of-breath?
What is suspected?
1) Chest x-ray
2) Lymphoma at mediastinum
If watchful waiting of a LN is the plan what should always be done?
Schedule a follow-up with patient and tell them to return right away if things get worse
If a biopsy must be done on a suspicious LN what type of biopsy is best?
Excisional biopsy
What is the most common tumor-like lesions of infancy that can involve cavernous, capillary or port wine stain “birthmarks”?
Hemangioma
What is Sturge Weber syndrome?
What is the hallmark?
1) Leptomeningeal angiomas
2) Facial port wine stain
In regards to hemangiomas any growth or deep dimple over what area of a baby should raise concern?
What should be done?
1) Lumbar/sacral area
2) MRI or US to check for spinal cord or vertebral abnormality
What are fibrosarcomas?
A malignant neoplasm where fibroblasts divide excessively without cellular control
What is a tumor of sympathetic ganglia and adrenal medulla?
Where is it derived from?
1) Neuroblastoma
2) Primordial NCC
What do 90% of neuroblastomas produce?
What levels are elevated in neuroblastoma?
If it is cutaneous what descriptive symptom do they have?
1) Catecholamines
2) Urine VMA and HVA (catecholamine breakdown products)
2) Blueberry muffin baby
What is the most common primary renal tumor of childhood with peak incidence between 2-5 years of age?
About 5 to 10% of theses tumors invovle?
1) Wilms tumor
2) Both kidneys
Risk of Wilms Tumor is increased with what congenital malformation?
Beckwith-Wiedemann syndrome
What are symptoms of Beckwith-Wiedemann syndrome?
1) Macroglossia
2) Organ enlargement
3) Omphalocele
4) Hemihypertrophy
