Lab Studies:
normal blood cell counts, electrolytes, kidney function and liver function.
erythrocyte sedimentation rate and c-reactive protein were within normal limits
Other Studies:
Initial imaging included a chest X-Ray showing no acute rib or sternal fractures. In addition, an ultrasound of the anterior chest wall showed focal subcutaneous thickening and hyperemia, but no drainable fluid collections. Case Photo #2 Case Photo #3
Over the next ten weeks, her rash developed into an annular erythematous plaque with central clearing. Case Photo #4
A punch biopsy of the anterior chest wall performed by dermatology showed pan-dermal infiltrate of atypical lymphocytes extending into the deep dermis, positive for CD20. Computed tomography (CT) scans of the neck, chest, abdomen, and pelvis were negative for metastatic disease. Positron emission tomography (PET) scans showed increased fluorodeoxyglucose (FDG) avidity of the anterior chest wall lesions extending into the right pectoralis muscle, and minimal right axillary avidity. Case Photo #5 Case Photo #6
Consultations:
Dermatology
Pediatric Oncology
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