Aribo Chadé, Al Alonso, Woodall Allison, Kim Tommy Y
University of California Riverside.
Riverside Community Hospital.
HCA Healthc J Med. 2020 Aug 29;1(4):217-221. doi: 10.36518/2689-0216.1020. eCollection 2020.
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.
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.
Complete blood count showed pancytopenia with a white blood cell count of 4.4 × 10e3/uL, hemoglobin of 10.8 g/dL and platelets of 87 × 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.
The presence of supraclavicular lymphadenopathy should raise concern for non-infectious etiologies, such as malignant processes.
淋巴结病是一种常见的体格检查发现，常与感染性病因相关。我们报告一例患有广泛性颈部和锁骨上淋巴结病的患者，其被诊断为一种罕见的恶性肿瘤。医疗保健提供者应了解一些需要进一步调查的不常见的病史或体格检查发现。
一名16岁女性因发热、鼻塞、咽痛3天，伴有颌周肿胀而就诊于急诊科。她的体格检查发现包括双侧下颌肿胀以及广泛性颈部淋巴结病，可触及锁骨上淋巴结。
全血细胞计数显示全血细胞减少，白细胞计数为4.4×10³/μL，血红蛋白为10.8 g/dL，血小板为87×10³/μL。颈部增强CT扫描显示广泛性颈部和纵隔淋巴结病，怀疑为淋巴瘤。活检结果诊断为一种罕见的血液系统恶性肿瘤，称为母细胞性浆细胞样树突状细胞瘤。
锁骨上淋巴结病的存在应引起对非感染性病因（如恶性病变）的关注。
