Masses and Lymphadenopathy in Children Flashcards
what is lymphadenopathy?
lymph nodes that are abnormal in size, number, or consistency
what is the most important part of the workup of a child with lymphadenopathy?
the history and the PE- it’s a necessity
what are the reassuring qualities of a lymph node?
nodes where you expect them, soft, mobile, not warm, not red, not tender, and the patient is feeling ok over all
what are the more concerning qualities associated with a lymph PE?
multiple locations of nodes, very large nodes, matted and stuck down, fluctuant, tender, and associated with big liver/spleen
what should always be included in your PE in a child with lymphadenopathy?
you should always check the liver and spleen size (enlargement may be indicative of a malignancy or systemic infection)
what are two viral infections that could cause lymphadenopathy?
Epstein-barr virus and HIV
what does epstein-barr virus cause?
mononucleosis
how does mono present?
severe pharyngitis, cervical LAD, spleen enlargement, fatigue
how does HIV present in children?
wasting and diffuse lymphadenopathy
what are 4 bacterial infections that could cause lymphadenopathy?
cat-scratch disease, tularemia, staph/strep, and strep pyogenes
what is cat scratch disease?
Bartonella henselae infection resulting in axillary LAD
what is Tularemia?
caused from skinning rabbits
what should you look for in a patient you suspect has a staph/step infection?
look for lesion on skin in region of body that drains into the enlarged node
what does strep pyogens cause?
strep throat, cervical LAD with headache, stomach ache, and sore throat
what are three symptoms of lymphoma?
B signs, fatigue, SOB/dyspnea
what are the b signs?
fever, night sweats, and weight loss
if a child presents with lymphadenopathy and SOB what should you do?
order a chest x-ray–> lymphoma loves the mediastinum
if you get to the point of biopsy of a lymph node, which type is best?
excisional
What is the most common tumor like lesions of infancy (about 5% of all babies)?
hemangiomas
what is a hall mark of sturge weber syndrome?
facial port wine stain
what is seen in sturge weber syndrome?
leptomeningeal angiomas; associated with developmental delay/ intellectual disability
if you ever see any deep growth or dimple in an hemangioma over the lumbar/sacral area, what should you do?
order an MRI or US to check for spinal cord or vertebral abnormality
what is a neuroblastoma?
tumor of sympathetic ganglia and adrenal medulla
how does the baby appear if there is cutaneous dissemination of a neuroblastoma?
blueberry muffin baby
what is the most common primary renal tumor of childhood?
wilms tumor
when is the peak incidence of wilms tumor?
2-5 years of age
risk of wilms tumor is increased with the following 3 recognizable groups of congenital malformations?
Beckwith-Wiedemann syndrome, WAGR syndrome, and Denys-Drash syndrome
what is the most common primary ocular malignancy of childhood?
retinoblastoma
what does ewing sarcoma cause?
chronic bone pain in the area of the tumor
where does ewing sarcoma occur?
in bone or soft tissue around the bone
what are fibrosarcomas?
fibroblasts that divide excessively without cellular control
what is the most common malignancy in kids less than 10 years old?
leukemia
what is the most common malignancy in adolescents 15-19 years old?
hodgkin lymphoma
