Danielle Walsh

98 statements · 1 topic

Soft Tissue Sarcoma (lymph nodes) · guest expert

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I think a 6 year old with a single node in the neck that's not growing, I think the chance of lymphoma is almost zero.
quote · Soft Tissue Sarcoma (lymph nodes)
Silver nitrate actually has the lowest success rate, 15% recurrence rate with it.
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Danielle's statements about Soft Tissue Sarcoma (lymph nodes) 98 statements

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Lumps & Bumps: Soft Tissue Masses and Lesions

Statement Retinoid medications for acne are significantly associated with development of pyogenic granulomas; removal of medication often resolves the lesion Open
Statement Retinoid medications for acne are significantly associated with development of pyogenic granulomas; removal of medication often resolves the lesion Open
Statement Pyogenic granuloma surgical resection has approximately 3% recurrence rate with gross negative margins Open
Statement Pyogenic granuloma surgical resection has approximately 3% recurrence rate with gross negative margins Open
Quotation You do not need to take, um, a wider margin, so about a 3% recurrence rate with that. Open
Quotation You do not need to take, um, a wider margin, so about a 3% recurrence rate with that. Open
Statement Shave excision with curettage of pyogenic granuloma has 9.5% recurrence rate Open
Statement Shave excision with curettage of pyogenic granuloma has 9.5% recurrence rate Open
Quotation Silver nitrate actually has the lowest success rate, 15% recurrence rate with it. Open
Statement Silver nitrate treatment for pyogenic granuloma has 15% recurrence rate, the highest among treatment options Open
Statement Silver nitrate treatment for pyogenic granuloma has 15% recurrence rate, the highest among treatment options Open
Quotation Silver nitrate actually has the lowest success rate, 15% recurrence rate with it. Open
Quotation You're not gonna get a path specimen, and it may require multiple treatments. Open
Quotation You're not gonna get a path specimen, and it may require multiple treatments. Open
Statement In a large study, 80% of characteristic Spitz nevi involuted spontaneously Open
Statement In a large study, 80% of characteristic Spitz nevi involuted spontaneously Open
Statement Half of pediatric dermatologists would observe classic Spitz nevi without excision, waiting for spontaneous resolution Open
Statement Half of pediatric dermatologists would observe classic Spitz nevi without excision, waiting for spontaneous resolution Open
Statement In a series of 30 patients with incompletely removed Spitz nevi, 24 were observed and none recurred; 6 were re-excised and only 1 had residual disease Open
Statement In a series of 30 patients with incompletely removed Spitz nevi, 24 were observed and none recurred; 6 were re-excised and only 1 had residual disease Open
Statement In a retrospective study with 1-3mm margins for Spitz nevi, 20% had positive margins on re-excision Open
Statement In a retrospective study with 1-3mm margins for Spitz nevi, 20% had positive margins on re-excision Open
Statement Barnhill recommends 3-5mm margins for classic Spitz nevi, 1cm for atypical, and melanoma-protocol margins for severely atypical based on depth Open
Statement Barnhill recommends 3-5mm margins for classic Spitz nevi, 1cm for atypical, and melanoma-protocol margins for severely atypical based on depth Open
Statement About one-third of Spitz nevi cases had nodal micrometastases on sentinel lymph node biopsy in combined adult and pediatric series Open
Statement About one-third of Spitz nevi cases had nodal micrometastases on sentinel lymph node biopsy in combined adult and pediatric series Open
Statement In 8 series, 39% of Spitz nevi with sentinel lymph node biopsy were positive, but all patients remained disease-free at 3-year follow-up without further intervention Open
Statement In 8 series, 39% of Spitz nevi with sentinel lymph node biopsy were positive, but all patients remained disease-free at 3-year follow-up without further intervention Open
Quotation 24 patients. Uh, well, small studies. We got not a lot of these in kids, all right, but we see them. We see it. We've, I, I suspect all of us have seen at least a few. Open
Quotation 24 patients. Uh, well, small studies. We got not a lot of these in kids, all right, but we see them. We see it. We've, I, I suspect all of us have seen at least a few. Open
Statement Pediatric melanoma ABCDE criteria capture only 40% of cases in children under 10 and 60% in children over 11 Open
Statement Pediatric melanoma ABCDE criteria capture only 40% of cases in children under 10 and 60% in children over 11 Open
Statement Melanoma margin recommendations: 5mm for in situ, 1cm for ≤1mm thick, 1-2cm for 1-2mm thick, 2cm for >2mm thick Open
Statement Melanoma margin recommendations: 5mm for in situ, 1cm for ≤1mm thick, 1-2cm for 1-2mm thick, 2cm for >2mm thick Open
Statement Cochrane review suggests 2cm margins are adequate for thick melanomas; no benefit demonstrated for 4cm margins Open
Statement Cochrane review suggests 2cm margins are adequate for thick melanomas; no benefit demonstrated for 4cm margins Open
Statement Giant congenital nevi (>20cm) have 8% melanoma risk, higher if hairy; 60% of melanomas occur in first decade, reported as young as 3 years Open
Statement Giant congenital nevi (>20cm) have 8% melanoma risk, higher if hairy; 60% of melanomas occur in first decade, reported as young as 3 years Open
Statement Pediatric melanoma has higher metastatic rate to lymph nodes (about 25%) than adults, especially in children younger than 10 and with thicker lesions Open
Statement Pediatric melanoma has higher metastatic rate to lymph nodes (about 25%) than adults, especially in children younger than 10 and with thicker lesions Open
Statement If sentinel node is negative in melanoma, probability of subsequent recurrence is only about 5% Open
Statement If sentinel node is negative in melanoma, probability of subsequent recurrence is only about 5% Open
Statement If sentinel node is negative in melanoma, probability of non-sentinel node being positive is low but not zero Open
Statement If sentinel node is negative in melanoma, probability of non-sentinel node being positive is low but not zero Open
Quotation I would not operate on this. I, I would do a CBC and a chest X-ray, and the main reason for doing those is because they're virtually always normal and it helps to reassure the family. Open
Quotation I would not operate on this. I, I would do a CBC and a chest X-ray, and the main reason for doing those is because they're virtually always normal and it helps to reassure the family. Open
Quotation I think a 6 year old with a single node in the neck that's not growing, I think the chance of lymphoma is almost zero. Open
Quotation I think a 6 year old with a single node in the neck that's not growing, I think the chance of lymphoma is almost zero. Open
Statement Acute unilateral cervical lymphadenopathy is mostly bacterial (strep and staph); acute bilateral is usually viral Open
Statement Acute unilateral cervical lymphadenopathy is mostly bacterial (strep and staph); acute bilateral is usually viral Open
Statement Chronic/subacute unilateral lymphadenopathy suggests atypical mycobacteria, Bartonella, tuberculosis, or toxoplasmosis Open
Statement Chronic/subacute unilateral lymphadenopathy suggests atypical mycobacteria, Bartonella, tuberculosis, or toxoplasmosis Open
Statement Chronic/subacute bilateral lymphadenopathy suggests EBV, CMV, or HIV Open
Statement Chronic/subacute bilateral lymphadenopathy suggests EBV, CMV, or HIV Open
Statement Lymphadenopathy may persist 6-8 weeks after antibiotic treatment Open
Statement Lymphadenopathy may persist 6-8 weeks after antibiotic treatment Open
Statement Biopsy indications for cervical lymphadenopathy include: >3cm, hard/fixed, supraclavicular or epitrochlear location, multiple nodal groups, systemic symptoms, hepatosplenomegaly, significantly abnormal labs, or abnormal imaging Open
Statement Biopsy indications for cervical lymphadenopathy include: >3cm, hard/fixed, supraclavicular or epitrochlear location, multiple nodal groups, systemic symptoms, hepatosplenomegaly, significantly abnormal labs, or abnormal imaging Open
Statement FNA for lymph nodes has 90% sensitivity and specificity but 10% false rate, with higher false-negative rate in Hodgkin lymphoma Open
Statement FNA for lymph nodes has 90% sensitivity and specificity but 10% false rate, with higher false-negative rate in Hodgkin lymphoma Open
Statement Malignancy rate in cervical lymph node biopsies varies 10-25% overall but ranges 12-80% depending on referral patterns and specialty Open
Statement Malignancy rate in cervical lymph node biopsies varies 10-25% overall but ranges 12-80% depending on referral patterns and specialty Open
Statement Atypical mycobacterial lymphadenitis is a local problem in immunocompetent children, usually age 1-5 years, enters through oropharynx, and is not considered contagious Open
Statement Atypical mycobacterial lymphadenitis is a local problem in immunocompetent children, usually age 1-5 years, enters through oropharynx, and is not considered contagious Open
Statement In a randomized multicenter trial for atypical mycobacterial lymphadenitis, surgery had 96% cure rate versus 66% cure rate with antibiotics alone Open
Statement In a randomized multicenter trial for atypical mycobacterial lymphadenitis, surgery had 96% cure rate versus 66% cure rate with antibiotics alone Open
Statement In a series of 55 patients with confirmed atypical mycobacteria, 45 started on antibiotics and 30 (67%) resolved without surgery Open
Statement In a series of 55 patients with confirmed atypical mycobacteria, 45 started on antibiotics and 30 (67%) resolved without surgery Open
Statement Neonatal breast mastitis occurs mostly in term or near-term infants due to estrogen exposure; very uncommon in preemies because estrogen levels don't rise Open
Statement Neonatal breast mastitis occurs mostly in term or near-term infants due to estrogen exposure; very uncommon in preemies because estrogen levels don't rise Open
Statement Peak age for neonatal mastitis is 2-4 weeks; majority are staph but gram negatives reported Open
Statement Peak age for neonatal mastitis is 2-4 weeks; majority are staph but gram negatives reported Open
Statement Parenteral antibiotics for 7-14 days may be needed for neonatal mastitis because infants have delayed absorption and delayed antibiotic efficacy Open
Statement Parenteral antibiotics for 7-14 days may be needed for neonatal mastitis because infants have delayed absorption and delayed antibiotic efficacy Open
Statement In two small series of neonatal mastitis with I&D, breast deformity occurred in 2 of 5 patients (40%) in one study and 2 of 7 patients (29%) in another Open
Statement In two small series of neonatal mastitis with I&D, breast deformity occurred in 2 of 5 patients (40%) in one study and 2 of 7 patients (29%) in another Open
Statement Fibroadenomas are the most common breast lesion in the under-20 age group, representing an exaggerated response to estrogen Open
Statement Fibroadenomas are the most common breast lesion in the under-20 age group, representing an exaggerated response to estrogen Open
Statement About 10-15% of fibroadenomas are multiple and 10% are bilateral Open
Statement About 10-15% of fibroadenomas are multiple and 10% are bilateral Open
Statement Fibroadenomas typically increase in size over 6-12 months, then stabilize and can regress completely Open
Statement Fibroadenomas typically increase in size over 6-12 months, then stabilize and can regress completely Open
Statement Excisional biopsy for fibroadenoma is recommended if continuing to grow, changing, over 5cm, symptomatic, complex on ultrasound, unreliable follow-up, or severe family anxiety Open
Statement Excisional biopsy for fibroadenoma is recommended if continuing to grow, changing, over 5cm, symptomatic, complex on ultrasound, unreliable follow-up, or severe family anxiety Open
Statement Juvenile fibroadenomas are larger lesions with rapid growth, greater than 5cm, but only 10% reach that size Open
Statement Juvenile fibroadenomas are larger lesions with rapid growth, greater than 5cm, but only 10% reach that size Open
Statement Juvenile fibroadenomas larger than 5cm are difficult to distinguish from cystosarcoma phyllodes, even on percutaneous biopsy Open
Statement Juvenile fibroadenomas larger than 5cm are difficult to distinguish from cystosarcoma phyllodes, even on percutaneous biopsy Open
Statement Simple fibroadenomas (isolated, well-demarcated, solid) have no increased cancer risk if no family history and no adjacent breast tissue abnormality Open
Statement Simple fibroadenomas (isolated, well-demarcated, solid) have no increased cancer risk if no family history and no adjacent breast tissue abnormality Open
Statement Complex fibroadenomas (with cysts, calcifications, or abnormal surrounding tissue) carry a slight increased risk of future breast cancer up to 20 years after diagnosis Open
Statement Complex fibroadenomas (with cysts, calcifications, or abnormal surrounding tissue) carry a slight increased risk of future breast cancer up to 20 years after diagnosis Open
Statement Malignant breast disease in pediatric patients is rare and more commonly metastatic from other sites than primary breast tumors Open
Statement Malignant breast disease in pediatric patients is rare and more commonly metastatic from other sites than primary breast tumors Open
Statement Lymphoma patients treated with chest radiation at young ages have up to 25% higher incidence of malignant breast disease Open
Statement Lymphoma patients treated with chest radiation at young ages have up to 25% higher incidence of malignant breast disease Open
Statement American Society of Clinical Oncology discourages BRCA genetic testing before age 20 due to lack of timely medical benefit and psychosocial risks Open
Statement American Society of Clinical Oncology discourages BRCA genetic testing before age 20 due to lack of timely medical benefit and psychosocial risks Open