#july2020amc1
A 1-year-old girl presents with shortness of breath. Her parents have also noticed that her eyes no longer look symmetrical. The right pupil is smaller than the left and the right eyelid appears droopy. A chest X-ray shows increased opacification in the right hemi-thorax, particularly in the right upper zone. Which one of the following is the most likely diagnosis?
A. Community acquired pneumonia
B. Congenital diaphragmatic hernia
C. Congenital pulmonary airway malformations
D. Lymphoma
E. Neuroblastoma
Explanatory Notes:
The clinical features point to a right sided Horner syndrome, secondary to a right apical tumour compressing the sympathetic chain. In this age group the most likely cause is neuroblastoma.
A community acquired pneumonia - although a pneumonia can present with shortness of breath, the Horner syndrome is not in keeping. A congenital diaphragmatic hernia - although late presenting congenital diaphragmatic hernia can present with shortness of breath, the Horner syndrome is not in keeping. A congenital pulmonary airway malformations - although late presenting congenital pulmonary airway malformation can present with shortness of breath (usually because of infection in the CPAM), the Horner syndrome is not in keeping Lymphoma - lymphoma causes lymph node enlargement. The chest X-ray may typically show a mediastinal mass Neuroblastoma - correct
A 1-year-old girl presents with shortness of breath. Her parents have also noticed that her eyes no longer look symmetrical. The right pupil is smaller than the left and the right eyelid appears droopy. A chest X-ray shows increased opacification in the right hemi-thorax, particularly in the right upper zone. Which one of the following is the most likely diagnosis?
A. Community acquired pneumonia
B. Congenital diaphragmatic hernia
C. Congenital pulmonary airway malformations
D. Lymphoma
E. Neuroblastoma
Explanatory Notes:
The clinical features point to a right sided Horner syndrome, secondary to a right apical tumour compressing the sympathetic chain. In this age group the most likely cause is neuroblastoma.
A community acquired pneumonia - although a pneumonia can present with shortness of breath, the Horner syndrome is not in keeping. A congenital diaphragmatic hernia - although late presenting congenital diaphragmatic hernia can present with shortness of breath, the Horner syndrome is not in keeping. A congenital pulmonary airway malformations - although late presenting congenital pulmonary airway malformation can present with shortness of breath (usually because of infection in the CPAM), the Horner syndrome is not in keeping Lymphoma - lymphoma causes lymph node enlargement. The chest X-ray may typically show a mediastinal mass Neuroblastoma - correct
Last edited: