Children with enlarged supraclavicular nodes, fever of one week duration, and weight loss should undergo biopsy. These features suggest lymphoma. CXR may disclose mediastinal adenopathy.
The local character of the lymph node is important. Firm, tender nodes with warmth and erythema of the skin suggest a bacterial source. Enlarged, nontender, fixed, rubbery hard nodes are suspicious for malignancy. Nodes in the low neck and supraclavicular fossa are particularly suspicious. Nodes less than 3mm in diameter are normal.
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