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Lymphoma — RACP Paediatrics MCQ

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HardIDLymphomaRACP Paediatrics

A 14-year-old presents with a painless enlarging left supraclavicular lymph node (4 cm, firm, rubbery) that has been present for 6 weeks. There is associated drenching night sweats and 5 kg unintentional weight loss. FBC shows a normocytic anaemia and elevated ESR. What is the most likely diagnosis?

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Correct answer: A — Lymphoma

A firm, painless, supraclavicular lymph node with B symptoms (night sweats, weight loss >10% body weight) and elevated inflammatory markers in an adolescent is highly concerning for lymphoma (Hodgkin lymphoma is most common in this age group). Urgent excisional biopsy is required. Supraclavicular nodes are always considered pathological.

Reference: RCH Melbourne – 2023 – Cervical Lymphadenopathy CPG; RACP Paediatric Curriculum – Oncology