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| | [[File:ImageLymphadenopathy.jpg|300px|thumb|right|Lymphadenopathy]] |
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| __NOTOC__ | | __NOTOC__ |
| {{Infobox_Disease | | | {{Lymphadenopathy}} |
| Name = Lymphadenopathy |
| | {{CMG}},{{shyam}};{{AE}} {{ADS}}, {{RT}} [[Ogechukwu Hannah Nnabude, MD]] |
| ICD10 = {{ICD10|I|88||i|80}}, {{ICD10|L|04||l|00}}, {{ICD10|R|59|1|r|50}} |
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| ICD9 = {{ICD9|289.1}}-{{ICD9|289.3}}, {{ICD9|683}}, {{ICD9|785.6}} |
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| ICDO = |
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| Image = Lymphadenopathy 001.jpg|
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| Caption = Lymphadenopathy|
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| OMIM = |
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| MedlinePlus = |
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| eMedicineSubj = |
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| eMedicineTopic = |
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| DiseasesDB = 22225 |
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| MeshID = D008206 |
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| }}
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| {{SI}}
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| {{CMG}}; {{AE}} {{RT}}
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| '''''Synonyms and keywords:''''' Lymph nodes enlarged, enlarged lymph nodes, lymphadenitis
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| | {{SK}} Lymph nodes enlarged; Enlarged lymph nodes; Lymphadenitis; Swollen lymph nodes; Swollen/enlarged lymph nodes<br> |
| | '''For patient information, click [[Xyz (patient information)|here]]''' |
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| ==Overview== | | ==Overview== |
| '''Lymphadenopathy''' is a term meaning "disease of the [[lymph nodes]]." It is, however, almost synonymously used with "swollen/enlarged lymph nodes".
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| When the infection is of the lymph nodes themselves, it is called '''lymphadenitis''', but when the infection is of the lymph channels, it is called '''[[lymphangitis]]'''.
| | ==[[Lymphadenopathy classification|Classification]]== |
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| The major lymph node groups are located along the anterior and posterior aspects of the neck and on the underside of the jaw. If the nodes are quite big, you may be able to see them bulging under the skin, particularly if the enlargement is asymmetric (i.e. it will be more obvious if one side is larger then the other). To palpate, use the pads of all four fingertips as these are the most sensitive parts of your hands. Examine both sides of the head simultaneously, walking your fingers down the area in question while applying steady, gentle pressure. The major groups of lymph nodes as well as the structures that they drain, are listed below. The description of drainage pathways are rough approximations as there is frequently a fair amount of variability and overlap. Nodes are generally examined in the following order:
| | ==[[Lymphadenopathy pathophysiology|Pathophysiology]]== |
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| ==Pathophysiology== | | ==Histopathology== |
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| ==Causes== | | ==Causes== |
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| ==Differentiating from other diseases== | | ==[[Lymphadenopathy differential diagnosis|Differentiating Lymphadenopathy from other Diseases]]== |
| | | ==[[Epidemiology and Demographics]]== |
| ==Epidemiology and Demogaphics== | |
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| ==Risk factors==
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| ==Natural history, Complications, Prognosis==
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| ==Diagnosis==
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| ===Symptoms===
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| ===Physical examination===
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| ===Lab findings=== | | ==Laboratory Evaluation of Lymphadenopathy== |
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| | ==Diagnostic Radiological Testing== |
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| ===Imaging===
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| ==Treatment== | | ==Treatment== |
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| ==Lymphadenopathy associated conditions==
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| Enlarged lymph nodes are a common symptom in a number of infectious and cancerous diseases. It is a recognized symptom of many diseases, which include:
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| * reactive: acute [[infection]] (e.g. [[bacterial]], or [[virus|viral]]), or chronic infections ([[tuberculous lymphadenitis]], [[cat-scratch disease]]).
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| ** Infectious [[mononucleosis]] is an acute viral infection, the hallmark of which is marked enlargement of the [[cervical lymph nodes]].
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| ** it is also a symptom of cutaneous [[anthrax]], [[measles]] and [[sleeping sickness|Human African trypanosomiasis]], the latter two giving lymphadenopathy in lymph nodes in the neck
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| **[[toxoplasmosis]], a [[parasitic disease]], gives a generalized lymphadenopathy<ref name=Status/>
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| * [[tumoral]]:
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| ** Primary: [[Hodgkin lymphoma]], [[non-Hodgkin lymphoma]], [[hairy cell leukemia]], give lymphadenopathy in all or a few lymph nodes <ref name=Status> Status and anamnesis, Anders Albinsson. Page 12 </ref>
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| ** Secondary: [[metastasis]], [[Virchow's Node]], [[Neuroblastoma]]
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| * [[autoimmune]] etiology: [[sarcoidosis]], [[systemic lupus erythematosus]], [[rheumatoid arthritis]] all giving a generalized lymphadenopathy.<ref name=Status/>
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| * immunocompromised etiology: [[AIDS]]. Generalized lymphadenopathy is an early sign of infection with [[human immunodeficiency virus]] (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS). "Lymphadenopathy syndrome" has been used to describe the first symptomatic stage of [[HIV]] progression, preceding [[AIDS-related complex]] and full-blown [[AIDS]].<ref>{{cite web|url=http://www.aproposinc.com/hap/types.htm|title=Understanding and Preventing AIDS: A Book for Everyone|author=Chris Jennings|year=1993}}</ref>
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| == Diagnosis ==
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| ===Patterns of Benign (Reactive) Lymphadenopathy===
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| There are three distinct patterns of benign lymphadenopathy:
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| * Follicular hyperplasia. Seen in infections, autoimmune disorders, and nonspecific reactions.
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| * Paracortical hyperplasia. Seen in viral infections, skin diseases, and nonspecific reactions.
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| * Sinus histiocytosis. Seen in lymph nodes draining limbs, inflammatory lesions, and malignancies.
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| ===Bihilar lymphadenopathy===
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| Bihilar lymphadenopathy is a [[radiography|radiographic]] term that describes the enlargement of [[mediastinal]] [[lymph]] nodes. It is easily and most commonly identified by a [[chest x-ray]]. The causes can divide into the four commonest:
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| *[[Tuberculosis]]
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| *[[Sarcoidosis]]
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| *[[Lymphoma]]
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| *Other malignancies
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| Less common causes include:
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| *[[Churg-Strauss syndrome]]
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| *[[Human Immunodeficiency Virus]]
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| *[[Extrinsic allergic alveolitis]]
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| *[[Pneumoconiosis]]
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| === Physical Examination ===
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| === Chest X Ray ===
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Sarcoidosis_Lymphadenopathy.jpg|Sarcoidosis bilateral hilar lymphadenopathy, non-caseating granulomas <ref>http://picasaweb.google.com/mcmumbi/USMLEIIImages</ref>
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| </gallery>
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| </div>
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| ==Diagnostic Findings==
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| (Images courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:head_scc1.jpg|Cervical Adenopathy: Massive right side cervical adenopathy and facial assymetry due to metastatic, intraoral squamous cell cancer.
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| Image:head_scc2.jpg|Cervical Adenopathy: Massive right side cervical adenopathy and facial assymetry due to metastatic, intraoral squamous cell cancer.
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| Image:head_cervical_ln.jpg|Cervical Adenopathy: Large right anterior cervical lymph node.
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| Image:head_cneck_adenop1.jpg|Cervical Adenopathy: Multiple right sided cervical lymph nodes.
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| </gallery>
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| </div>
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| == Differential Diagnosis of Causes of {{PAGENAME}}==
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| In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
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| * A. catarrhalis
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| * [[Anthrax]]
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| * [[Aphthous stomatitis]]
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| * [[Breast Cancer]]
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| * [[Brucellosis]]
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| * [[Cat scratch fever]]
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| * [[Erysipelas]]
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| * [[German Measles]]
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| * Hemoblastosis
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| * Histoblastosis
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| * [[Hodgkin's Lymphoma]]
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| * Idiopathic
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| * [[Infectious mononucleosis]]
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| * [[Influenza]]
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| * [[Listeriosis]]
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| * [[Leukemia]]
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| * [[Lymphangitis]]
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| * Lymphatic leukemia
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| * [[Mastitis]]
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| * [[Measles]]
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| * Metastatic tumor
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| * [[Mumps]]
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| * [[Pancoast tumor]]
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| * Reticulosis
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| * [[Streptococcal]] tonsillitis
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| * [[Systemic Lupus Erythematosus]]
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| * Three-day fever
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| * [[Toxoplasmosis]]
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| * [[Tuberculosis]]
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| * [[Tularemia]]
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| * Vaccination
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| * [[Varicella]]
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| * [[Vincent's angina]]
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| * [[Waldenstrom's Syndrome]]
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| ==References== | | ==References== |
| {{Reflist|2}} | | {{Reflist|2}} |
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| | [[Category: Oncology]] |
| [[Category:Inflammations]] | | [[Category:Inflammations]] |
| [[Category:Dermatology]] | | [[Category:Dermatology]] |
| [[Category:Signs and symptoms]] | | [[Category:Medical signs]] |
| [[Category:Infectious disease]] | | [[Category: Signs and symptoms]] |
| [[Category:Hematology]]
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| [[Category:Oncology]]
| | [[Category: Physical examination]] |
| [[Category:Physical examination]] | | |
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| <br>
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| [[de:Lymphadenopathie]]
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| [[fr:Adénopathie]]
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| [[he:לימפדנופתיה]]
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| [[id:Limfadenopati]]
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| [[lt:Limfadenitas]]
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| [[pt:Linfadenopatia]]
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| [[ru:Лимфаденопатия]]
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| [[pl:Limfadenopatia]]
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