84. 六歲女孩有淋巴腺腫大( Lymphadenopathy) 2周，以下何者情況需考慮切片檢查？
(A)頸部淋巴腺直徑0.5 公分。
(B)無合併體重減輕。
(C)腹股溝淋巴腺直徑1公分。
(D)淋巴腺有壓痛。
(E)上鎖骨淋巴腺直徑1公分。

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統計： A(0), B(0), C(3), D(3), E(59) #2086136

詳解 (共 2 筆)

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Nelson chapter517 Ly...
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Worrisome features — In children with peripheral lymphadenopathy, worrisome clinical features include [1-6]:

●Systemic symptoms (fever >1 week, night sweats, weight loss [>10 percent of body weight])

●Supraclavicular (lower cervical) nodes (see 'Supraclavicular lymphadenopathy' below)

●Generalized lymphadenopathy (see 'Generalized lymphadenopathy' below)

●Fixed, nontender nodes in the absence of other symptoms (see 'Lymph nodes' below)

●Lymph nodes of >1 cm (0.4 inches) with onset in the neonatal period (<1 month of age)

●Lymph nodes >2 cm (0.8 inches) in diameter that have increased in size from baseline or have not responded to two weeks of antibiotic therapy

●Abnormal chest radiograph, particularly mediastinal mass or hilar adenopathy (see 'Chest radiograph' below)

●Abnormal CBC and differential (eg, lymphoblasts, cytopenias in more than one cell line) (see 'CBC and ESR/CRP' below)

●Elevated LDH

●Lack of infectious symptoms in the ear, nose, and throat regions

●Persistently elevated ESR/CRP or rising ESR/CRP despite antibiotic therapy

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