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January 1985

Radiological Case of the Month

Author Affiliations

Contributed from the Departments of Radiology (Drs Seibert and Sandefur) and Pediatric Pathology (Dr Jimenez), Arkansas Children's Hospital and the University of Arkansas for Medical Sciences, Little Rock.

Am J Dis Child. 1985;139(1):101-102. doi:10.1001/archpedi.1985.02140030107043

This 14-year-old girl presented with a six-month history of amenorrhea, 9-kg weight loss, and a recent onset of back pain and fever to 38.9 °C. Four months prior to being admitted to the hospital, she had experienced the onset of a recurrent cough. A diagnosis of pneumonia was made and the condition was treated with an unidentified antibiotic.

The patient was a thin, pale girl with expiratory wheezes and nonlocalized abdominal tenderness. Laboratory studies showed a microcytic, hypochromic anemia with the following laboratory values: hematocrit, 26.6%; WBC count, 10,000/cu mm, with a normal differential cell count; and an ESR of 67 mm/hr. Serum electrolyte values and results of hepatic, renal, and bone marrow studies were normal. Blood and urine cultures, febrile agglutinins, fungal skin tests, and serology tests were negative.

A chest roentgenogram (Fig 1) and a computed tomographic examination of the chest, including the upper abdomen (Fig 2), were

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