PEM Source

Your source for all things Pediatric Emergency Medicine


Question: Onc

(Click the link to comment and to vote – voting not working through email, sorry!)

You are seeing a 3 year old whose parent noticed a lump in the neck while bathing her. You palpate posterior cervical node(s). 

Which of the following history or physical exam finding is least concerning for malignancy?

pemsou5_wp • October 26, 2021

Previous Post

Next Post


  1. Kelly October 29, 2021 - 9:31 am Reply

    C) Bilateral nodes
    The vast majority of palpable lymph nodes in young children are normal or reactive. Lymph nodes that are < 1cm, mobile, rubbery, nontender, not supraclavicular in location, and not associated with B symptoms (fever, night sweats, easy bleeding / bruising, weight loss, fatigue) are less concerning for malignancy. Firm matted large nontender nodes, particularly when associated with B symptoms, pallor, hepatosplenomegaly, bone pain, or symptoms of a mediastinal mass are concerning. Bilateral nodes are less concerning than unilateral; bilateral nodes are more often associated with infectious causes (reactive, EBV, CMV, cat-scratch).

Leave a Reply

Your email address will not be published / Required fields are marked *