Case report: Langerhans cell histiocytosis presenting as massive cervical adenopathy and retropharyngeal thickening: importance of chest radiography and coordinated airway and anesthetic management.
OBJECTIVE
To demonstrate the importance of chest radiography and special anesthetic management in children with massive cervical adenopathy.


METHODS
Case report of an 8-month-old infant who presented to the emergency department with fever, drooling, and massive cervical and mediastinal adenopathy. Safe anesthetic management allowed for cervical lymph node biopsy, which showed Langerhans cell histiocytosis.


RESULTS
Chest imaging and special anesthetic techniques (intravenous anesthesia and positioning in the lateral decubitus position) should be considered for children with massive cervical and mediastinal adenopathy.


CONCLUSIONS
Interdisciplinary airway, radiographic, and anesthetic management is recommended for children who present with massive and cervical and mediastinal adenopathy.
Division of Otolaryngology, Department of Surgery, Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA. ushah@nemours.org
Udayan K
UK
Shah
Brian
B
Nicholas
Jennifer
J
Hurd
Susmita
S
Nesargi
Diana
D
Corao-Uribe
D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000209:etiology*; D000771:Anesthesia, Intravenous; D000778:Anesthetics, Dissociative; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D004630:Emergencies; D006646:Histiocytosis, Langerhans-Cell / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007223:Infant; D007649:Ketamine; D008197:Lymph Node Excision / Q000379:methods*; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging / Q000601:surgery; D009333:Neck / Q000601:surgery; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000209:etiology; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology; D011241:Prednisone / Q000627:therapeutic use; D013902:Radiography, Thoracic; D012798:Sialorrhea / Q000209:etiology; D014747:Vinblastine / Q000627:therapeutic use
D000778:Anesthetics, Dissociative; D014747:Vinblastine; D007649:Ketamine; D011241:Prednisone