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Virtual Pediatric Hospital: Thoracopaedia: An Imaging Encyclopedia of Pediatric Thoracic Disease: Case 41 Thoracopaedia: An Imaging Encyclopedia of Pediatric Thoracic Disease

Case 41

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

Chief Complaint:
Sixteen year old female with fevers and chest pain

Clinical History:
The patient was a 16 year old female who was born with a meningomyelocele. She now presents with a 1 month history of fevers of 40 degrees Centigrade and persistent right sided chest pain.

Clinical Physical Exam:

Clinical Labs:
Urine cultures were negative

Clinical Differential Diagnosis:
Urinary tract infection

Imaging Findings:
A chest film showed an anterior mediastinal mass. Review of spine films from 6 months earlier (not provided) demonstrated the mass to be present then, in retrospect. The mass was essentially unchanged over 6 months. A chest CT exam better defined the lesion.

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Imaging Differential Diagnosis:

Operative Findings:
A biopsy was performed.

Pathological Findings:
Pathological examination of the biopsy specimen showed findings diagnostic of Hodgkin's Disease.

Final Diagnosis:
Lymphoma, Hodgkin, Anterior Mediastinal

Follow-up and Prognosis:
The patient had an uncomplicated post-biopsy course.

Similar Cases:
Case 33, Case 34, Case 37, Case 38, Case 39, Case 40, Case 60


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