Masses and Lymphadenopathy in Children

Question 1

what is lymphadenopathy?

Answer 1

lymph nodes that are abnormal in size, number, or consistency

Question 2

what is the most important part of the workup of a child with lymphadenopathy?

Answer 2

the history and the PE- it’s a necessity

Question 3

what are the reassuring qualities of a lymph node?

Answer 3

nodes where you expect them, soft, mobile, not warm, not red, not tender, and the patient is feeling ok over all

Question 4

what are the more concerning qualities associated with a lymph PE?

Answer 4

multiple locations of nodes, very large nodes, matted and stuck down, fluctuant, tender, and associated with big liver/spleen

Question 5

what should always be included in your PE in a child with lymphadenopathy?

Answer 5

you should always check the liver and spleen size (enlargement may be indicative of a malignancy or systemic infection)

Question 6

what are two viral infections that could cause lymphadenopathy?

Answer 6

Epstein-barr virus and HIV

Question 7

what does epstein-barr virus cause?

Answer 7

mononucleosis

Question 8

how does mono present?

Answer 8

severe pharyngitis, cervical LAD, spleen enlargement, fatigue

Question 9

how does HIV present in children?

Answer 9

wasting and diffuse lymphadenopathy

Question 10

what are 4 bacterial infections that could cause lymphadenopathy?

Answer 10

cat-scratch disease, tularemia, staph/strep, and strep pyogenes

Question 11

what is cat scratch disease?

Answer 11

Bartonella henselae infection resulting in axillary LAD

Question 12

what is Tularemia?

Answer 12

caused from skinning rabbits

Question 13

what should you look for in a patient you suspect has a staph/step infection?

Answer 13

look for lesion on skin in region of body that drains into the enlarged node

Question 14

what does strep pyogens cause?

Answer 14

strep throat, cervical LAD with headache, stomach ache, and sore throat

Question 15

what are three symptoms of lymphoma?

Answer 15

B signs, fatigue, SOB/dyspnea

Question 16

what are the b signs?

Answer 16

fever, night sweats, and weight loss

Question 17

if a child presents with lymphadenopathy and SOB what should you do?

Answer 17

order a chest x-ray–> lymphoma loves the mediastinum

Question 18

if you get to the point of biopsy of a lymph node, which type is best?

Answer 18

excisional

Question 19

What is the most common tumor like lesions of infancy (about 5% of all babies)?

Answer 19

hemangiomas

Question 20

what is a hall mark of sturge weber syndrome?

Answer 20

facial port wine stain

Question 21

what is seen in sturge weber syndrome?

Answer 21

leptomeningeal angiomas; associated with developmental delay/ intellectual disability

Question 22

if you ever see any deep growth or dimple in an hemangioma over the lumbar/sacral area, what should you do?

Answer 22

order an MRI or US to check for spinal cord or vertebral abnormality

Question 23

what is a neuroblastoma?

Answer 23

tumor of sympathetic ganglia and adrenal medulla

Question 24

how does the baby appear if there is cutaneous dissemination of a neuroblastoma?

Answer 24

blueberry muffin baby

Question 25

what is the most common primary renal tumor of childhood?

Answer 25

wilms tumor

Question 26

when is the peak incidence of wilms tumor?

Answer 26

2-5 years of age

Question 27

risk of wilms tumor is increased with the following 3 recognizable groups of congenital malformations?

Answer 27

Beckwith-Wiedemann syndrome, WAGR syndrome, and Denys-Drash syndrome

Question 28

what is the most common primary ocular malignancy of childhood?

Answer 28

retinoblastoma

Question 29

what does ewing sarcoma cause?

Answer 29

chronic bone pain in the area of the tumor

Question 30

where does ewing sarcoma occur?

Answer 30

in bone or soft tissue around the bone

Question 31

what are fibrosarcomas?

Answer 31

fibroblasts that divide excessively without cellular control

Question 32

what is the most common malignancy in kids less than 10 years old?

Answer 32

leukemia

Question 33

what is the most common malignancy in adolescents 15-19 years old?

Answer 33

hodgkin lymphoma