Kirihetti Liyanage Neelika,  Kumbla Surekha

Final Pr. ID: Poster #: EDU-001

Post-transplant lymphoproliferative disorder (PTLD) is an important cause of morbidity and mortality which affects transplant recipients of solid organs and allogenic bone marrow transplants. Paediatric recipients of organs that require high levels of immunosuppression are the most susceptible population. Incidence and the frequency of PTLD in paediatric age group is consistently higher than it is in adults. There is insufficient recent literature on imaging features of PTLD in the paediatric age group.
Our purpose is to illustrate multi-modality imaging characteristics of PTLD affecting different organs and systems in a cohort of paediatric patients with biopsy proven PTLD. Read More

Authors:  Kirihetti Liyanage Neelika , Kumbla Surekha

Keywords:  PTLD, Transplant, Lymphadenopathy

Laucis Nicholas,  True-malhotra Aisha,  Leschied Jessica

Final Pr. ID: Poster #: CR-019

Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue neoplasm presenting as a mass in the subcutis or deep dermis in the extremities of children and young adults. Although previously regarded as ‘malignant’, due to its benign microscopic appearance and favorable prognosis, this tumor was categorized as an “intermediate tumor of uncertain differentiation” in the 2013 World Health Organization classification.

AFH is often misdiagnosed on imaging and pathology. We will present the unusual case of AFH with extensive lymphadenopathy and multiple episodes of anemia. The imaging findings will be illustrated with radiographic, ultrasound, MRI, and PET/CT exams. We will also present gross specimen and pathology images.

Our case involves a 9 year old male presenting with asymptomatic left upper arm and left chest wall masses for two years. A previous biopsy of the mass and a lymph node had been performed, showing juvenile capillary hemangioma and benign progressive germinal transformation, respectively. The patient had several prior episodes of anemia requiring multiple blood transfusions. Coagulopathy workup was negative, and it was postulated that bleeding into the mass could be the source of the anemia.

Radiographs revealed a 4.5 cm ovoid mass in the posteromedial soft tissues of the upper left arm with stable size but increasing calcific serpiginous opacifications throughout the lesion compared to two years prior. Multiple round soft tissue nodules within the left axillary region were also present.

MRI revealed a heterogeneous lesion with a calcified rim with significant susceptibility artifact likely from hemosiderin. Several enlarged adjacent lymph nodes were present with additional marked lymphadenopathy filling the left axilla abutting the brachial plexus and neurovascular bundles, extending superiorly above the acromion. The largest lymph node measured 2.8 cm within a cluster of lymphadenopathy measuring 9 x 4 x 4 cm, increased compared to MRI two years prior. PET/CT revealed increased radiotracer uptake in the mass with a max SUV of 4.5 and within the left axillary lymphadenopathy with a max SUV of 6.5.

The patient underwent surgical excision of the mass with dissection and removal of two adjacent palpable lymph nodes. The mass had a firm capsule with a red/myxoid appearance measuring 6.0 x 5.0 cm. Pathology of the mass was consistent with angiomatoid fibrous histiocytoma and pathology of the lymph nodes revealed reactive follicular hyperplasia. Read More

Authors:  Laucis Nicholas , True-malhotra Aisha , Leschied Jessica

Keywords:  angiomatoid fibrous histiocytoma, lymphadenopathy, mass

Navallas Maria,  Daneman Alan,  Amirabadi Afsaneh,  Wasserman Jonathan

Final Pr. ID: Poster #: SCI-067

To evaluate the diagnostic accuracy of US and the most useful sonographic features for diagnosing metastatic cervical adenopathy in pediatric patients with thyroid carcinoma Read More

Authors:  Navallas Maria , Daneman Alan , Amirabadi Afsaneh , Wasserman Jonathan

Keywords:  Thyroid carcinoma, cervical lymphadenopathy, ultrasound

Baig Farhan,  Zapala Matthew,  Kim Jane,  Durand Rachelle,  Cohen Pierre-alain,  Wattier Rachel,  Courtier Jesse

Final Pr. ID: Poster #: EDU-058

Cat-Scratch Disease (CSD) is an infectious disease that predominantly affects pediatric patients, usually ages 4-9 years old. The annual incidence is estimated at 4.5 patients per 100,000 population. CSD is primarily caused by B. henselae, an intracellular gram-negative bacillus; it is transmitted via scratch, lick, or bite from a cat. It presents with lymphadenopathy proximal to the site of inoculation; most commonly, this is axillary, epitrochlear, cervical, or inguinal lymphadenopathy. While CSD can be diagnosed clinically and has objective findings on histopathology, the imaging findings are unclear and have been debated in the literature. As such, we sought to clarify the multimodal imaging findings associated with CSD. We performed a review of the literature to highlight the existing radiological consensus. We also contribute several of our own new cases from our institution. Read More

Authors:  Baig Farhan , Zapala Matthew , Kim Jane , Durand Rachelle , Cohen Pierre-alain , Wattier Rachel , Courtier Jesse

Keywords:  Cat Scratch Disease, CSD, lymphadenopathy

Lucin Michael,  Faruqui Sami,  Watal Pankaj,  Sato Yutaka,  Price Nathan,  Sato T Shawn

Final Pr. ID: Poster #: EDU-096

In the pediatric population, lymphadenopathy may be caused by a variety of diseases including lymphoma. Accurate differentiation of a non-lymphomatous lymphoproliferative disorder from lymphoma and other lymphoproliferative disorders is important in determining appropriate management. Radiologic imaging including assessment of cervical, mediastinal, and hilar lymphadenopathy can often provide the critical clue needed for accurate diagnosis. Read More

Authors:  Lucin Michael , Faruqui Sami , Watal Pankaj , Sato Yutaka , Price Nathan , Sato T Shawn

Keywords:  Lymphadenopathy, Lymphoproliferative

Sandigo Saballos Isabela,  Arguello Fletes Gladys,  Fenton Laura

Final Pr. ID: Poster #: CR-002

Histiocytic necrotizing lymphadenitis, also known as Kikuchi-Fujimoto disease, is a benign, self-limited disorder, associated with B symptoms (fever, weight loss) and painful lymphadenopathy. The combination of lymphadenopathy with B symptoms in the pediatric population raises suspicion for malignant diseases such as lymphoma, neuroblastoma, and rhabdomyosarcoma. We evaluated a series of children with biopsy-proven histiocytic necrotizing lymphadenitis to assess for unique imaging characteristics. Read More

Authors:  Sandigo Saballos Isabela , Arguello Fletes Gladys , Fenton Laura

Keywords:  Benign causes of lymphadenopathy, CT Perinodal infiltration and necrosis, CT Nodal Necrosis