Imaging of childhood non-Hodgkin lymphoma: assessment by histologic subtype.

The types of childhood non-Hodgkin lymphoma (NHL) differ considerably from Hodgkin lymphoma and NHL seen in adults, both pathologically and clinically. Essential to understanding these differences is a knowledge of the three major histologic subtypes (undifferentiated, lymphoblastic, and large cell) that account for the vast majority of cases of pediatric NHL. Each of these subtypes has typical imaging and clinical features. The most common subtype, undifferentiated NHL, usually shows intraabdominal disease. Lymphoblastic tumors most frequently manifest as a mediastinal mass, perhaps with respiratory or circulatory compromise. Large cell tumors show heterogeneous clinical and imaging features but tend to spare the anterior mediastinum. Knowledge of the appropriate imaging modality to be used in evaluation of these tumors is also important. Computed tomography (CT) is the primary imaging modality for staging childhood NHL. Magnetic resonance imaging is best for examination of the central nervous system and bone involvement. Ultrasonography may be useful as a complementary study to abdominal CT; gallium scintigraphy also plays an adjunctive role to CT. Familiarity with typical and atypical patterns of tumoral behaviors and optimal imaging methods aid in the diagnosis and appropriate follow-up of these tumors.

Intervertebral disc calcification in children.

Calcification of cervical intervertebral discs in children is due to an uncommon, but distinct, disease of unknown etiology. Signs and symptoms of nerve root or spinal cord compression are unusual and acute symptoms are followed by a benign course and spontaneous recovery. We describe a 5-year-old patient with symptomatic cervical disc calcification and discuss the relevant clinical and radiographic features.

Osseous pseudotumor. The sole manifestation of sinus histiocytosis with massive lymphadenopathy.

Sinus histiocytosis with massive lymphadenopathy may involve extra-nodal tissue sites. Skeletal involvement is uncommon and has always been associated with disease in other nonosseous locations. The present case is the first to document sinus histiocytosis with massive lymphadenopathy arising primarily within bone and unaccompanied by disease elsewhere.

Enteric duplication cyst.

We have described a case of cystic duplication of the small bowel in a newborn with a palpable abdominal mass. Roentgenographic studies of this patient failed to show any intrinsic abnormalities of the gastrointestinal or genitourinary tracts. At surgery, a sausage-shaped enteric duplication of the ileum was removed.

Congenital kyphosis and subluxation of the thoraco-lumbar spine due to vertebral aplasia.

Vertebral body aplasia or hypoplasia leads to rapidly progressive spinal deformity and neurologic defects when unrecognized in infancy. Four patients with this unusual defect are described.

Bronchopulmonary sequestration: an unusual presentation.

We have described a case of extralobar sequestration involving the left upper lobe in a 4-year-old boy. The etiology of this anomaly remains obscure, but it may result from a supranumerary lung bud arising from the pharynx. Unlike intralobar sequestrations, extralobar sequestrations frequently have associated anomalies. Clinically the symptoms are variable. Our patient was cured by surgical excision of the lesion.

Retroperitoneal lipoma in children.

A case of retroperitoneal lipoma in a 23-mo old girl is reported together with a brief review of the 11 previously documented cases. It has been encountered through age 8 yr and twice as frequently in girls. The majority had an enlarged abdomen of long duration. The others were asymptomatic and found incidentally or at the time of examination for abdominal pain. Most lipomata were large. The possibility of their being congenital cannot be excluded. None have recurred.