lymphatic diseases; neoplasms; dendritic cells/pathology; hematologic neoplasms; leukemia; pediatrics
Emergency Medicine | Hematology | Hemic and Lymphatic Diseases | Medical Sciences | Neoplasms | Oncology | Pediatrics
Introduction: Lymphadenopathy is a common physical finding often associated with an infectious etiology. We present a case of a patient with generalized cervical and supraclavicular lymphadenopathy diagnosed with a rare malignancy. Health care providers should be aware of some uncommon historical or physical examination findings that warrant further investigation.
Clinical Findings: A 16-year-old female presented to the emergency department with 3 days of a fever, congestion and sore throat with swelling around the jaw. Her physical examination findings included bilateral mandibular swelling and generalized cervical lymphadenopathy with palpable supraclavicular lymph nodes.
Outcomes: Complete blood count showed pancytopenia with a white blood cell count of 4.4 x 10e3/uL, hemoglobin of 10.8 g/dL and platelets of 87 x 10e3/uL. CT scan of the neck with IV contrast revealed extensive cervical and mediastinal lymphadenopathy with suspicion of lymphoma. Biopsy results diagnosed a rare form of a hematologic malignancy called blastic plasmacytoid dendritic cell neoplasm.
Conclusions: The presence of supraclavicular lymphadenopathy should raise concern for non-infectious etiologies, such as malignant processes.
Aribo, Chade; Al, Alonso; Woodall, Allison; and Kim, Tommy Y.
"Investigation of a Peculiar Case of Childhood Lymphadenopathy,"
HCA Healthcare Journal of Medicine: Vol. 1:
4, Article 7.
Available at: https://scholarlycommons.hcahealthcare.com/hcahealthcarejournal/vol1/iss4/7