Snapshot A 9-year-old girl is brought to the free clinic by her parents. The family members are refugees from South Sudan who just settled into the United States a month ago. With the help of a translator, the pediatrician learns that the girl has experienced swelling in her left lower jaw for the past 15 days. The swelling is not painful but has caused difficulty chewing as it has rapidly increased in size in the past week. Physical examination reveals enlarged bilateral submandibular lymph nodes. An excisional lymph node biopsy is performed on her submandibular lymph nodes and is sent to pathology. Histology of the biopsy specimen is shown in the image. Introduction Overview login to view 1 more bullet Epidemiology login to view 6 more bullets Pathophysiology login to view 13 more bullets Genetics login to view 17 more bullets Prognosis login to view 4 more bullets Presentation Symptoms login to view 20 more bullets Physical exam login to view 5 more bullets Imaging CT scan of neck, chest, abdomen, and pelvis login to view 2 more bullets PET scanning login to view 2 more bullets Upper GI series login to view 3 more bullets MRI of brain and spinal cord login to view 2 more bullets Studies CBC login to view 1 more bullet LDH levels login to view 1 more bullet Serum β2-microglobulin login to view 1 more bullet Excisional lymph node biopsy login to view 1 more bullet Treatment Medical login to view 10 more bullets Surgical login to view 2 more bullets