Shadow is a 16 yr old fs DSH presented for weight loss and lethargy.  She had a fever of 104.4.  Her labs showed her to be hypert4 (t4 7.2) and she had an elevated WBC (43,000) with a left shift (2426 bands).  I was wondering about the hyperechoic material in this node.  The images are from around the ICCJ.