Abstract
A 6-year-old girl was admitted because of a low-grade fever of 5 days’ duration. She had an isolated, bulging, block of tender, firm, cervical lymph nodes, without erythema or increased temperature of the overlying skin. A full blood count showed white blood cells of 5.7×10/μl, with neutrophils 39%, lymphocytes 51%, monocytes 6%, and eosinophils 4%; hemoglobin level 12.7 g/dl; hematocrit 37.4%; platelets 340×10/μl. The findings of urine analysis were normal. The child was given clindamycin intravenously for 10 days, and the block of lymph nodes gradually resolved. Looking for abdominal masses or para-aortic lymph nodes, we found a discrete mass in the middle right kidney, incidentally identified by ultrasonography (Fig. 1a). We further explored this finding with color Doppler ultrasonography (Fig. 1b), technetium-99m dimercapto-succinic acid (Tc-DMSA) scan, and magnetic resonance (MR) imaging. Pediatr Nephrol (2010) 25:441–442 DOI 10.1007/s00467-009-1216-8
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