Pediatric emergency medicine trisk 2688 2688

Rapidly progressing
abdominal distention with
diffuse involvement of the
GI tract/liver with ascites
and pleural effusions
(advanced stage)
Diffuse large B-cell Painless, hard adenopathy at
lymphoma
any site,
neck/supraclavicular
common
AMM common, symptoms
variable (advanced)
Symptom progression can be
rapid (advanced stage)
Systemic symptoms of
malaise, weight loss
common with advanced
disease
GI symptoms/abdominal
mass from GI tract and
mesenteric nodes
involvement
Anaplastic large cell Painless, hard adenopathy at
lymphoma
any site
Skin/subcutaneous nodules
GI symptoms/abdominal
mass from GI tract and
mesenteric node
involvement

Systemic symptoms (fevers,
night sweats, weight loss,
malaise) common with
advanced disease

TLS
SVC syndrome
Tracheal obstruction

TLS

AMM, anterior mediastinal mass; G6PD, glucose-6-phosphate dehydrogenase.

Clinical Assessment
There may be useful clues to the diagnosis from the history and physical
examination. A recent history of new-onset asthma in an older child who responded