• T Ankermann, A Claviez, and M Suttorp.
• Klinik für Allgemeine Pädiatrie, Universitätsklinikum Schleswig-Holstein, Campus Kiel. ankermann@pediatrics.uni-kiel.de
• Dtsch. Med. Wochenschr. 2004 Mar 19; 129 (12): 613-6.

HistoryThree school children (2 girls and 1 boy, aged 9-15 years) complained about exercise-induced shortness of breath and stridor. The children were treated with inhalation steroids, one of them with systemic steroids, without a significant effect.InvestigationsBecause of lack of treatment response a chest X-ray was done. In all cases a mediastinal mass was visible. No radiological signs of an obstructive pulmonary disease was demonstrated. In none of the three cases did a pulmonary function tests demonstrate an obstructive pulmonary disease.Diagnosis, Treatment, And CourseBone marrow aspiration in one girl showed an acute lymphoblastic leukemia of T-cell immunophenotype with a large mediastinal lymphoma. Lymph node biopsy in the boy demonstrated a nodular sclerosing subtype of Hodgkin's disease. In the other girl a ganglioneuroma was found.ConclusionIn children and adolescents a chest radiograph and pulmonary function tests should be performed if history and clinical signs are suggestive of bronchial asthma, before a specific inhalative or systemic treatment is started.

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