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February 1997

Pathological Case of the Month

Author Affiliations

From the Departments of Pediatrics (Dr Buchino), Pathology (Drs Buchino and Yacoub), and Surgery (Dr Fallat), University of Louisville School of Medicine, Louisville, Ky; and the Department of Pathology (Drs Buchino and Yacoub and Ms McDaniel), Kosair Children's Hospital, Louisville, Ky.

Arch Pediatr Adolesc Med. 1997;151(2):205-206. doi:10.1001/archpedi.1997.02170390095019

A 9-YEAR-OLD girl was referred to a pediatric surgeon for what was thought to be persistent left axillary adenopathy of 1 month's duration. The child had received 2 consecutive 10-day courses of antibiotic therapy with no change in the axillary mass. There was no known exposure to tuberculosis; however, the patient had been exposed to many farm animals, including several kittens. The patient had no constitutional symptoms.

Findings on physical examination disclosed a firm, discrete, nontender, mobile mass palpable in the left anterior axillary fold measuring 2 cm in diameter. No generalized lymphadenopathy, scratches, or bites were present. The child was referred for fine-needle aspiration (Figure 1) and, subsequently, excision of the mass (Figure 2).

Diagnosis and Discussion  Granular Cell TumorThe differential diagnosis of an axillary mass in a child includes enlarged lymph nodes due to infectious causes such as pyogenic bacteria, cat scratch disease and mycobacteria, and lymphoma.

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