The most common initial manifestations of Hodgkin's disease in children are cervical or supraclavicular adenopathy or a mediastinal mass. Axillary and inguinal lymph node involvement are much less frequent. Epitrochlear involvement is very unusual, even in the presence of generalized disease and is extremely rare as an initial and isolated manifestation of Hodgkin's disease.
Report of a Case.—A healthy 6-year-old girl, had a firm, painless, 4-cm, right epitrochlear mass. There was no history of the systemic symptoms (ie, fever, sweats, weight loss, or pruritus), local infection, animal bites or scratches, or medications. The physical examination was otherwise unremarkable.
An excisional biopsy specimen demonstrated nodular sclerosing Hodgkin's disease. Clinical assessment included complete blood cell count, sedimentation rate, liver function tests, chest tomography, gallium scan, liver-spleen scan, bipedal lymphangiography, intravenous pyelogram and bilateral posterior iliac crest bone marrow aspirates, and biopsy specimens, all of which showed no evidence of lymphoma. A