Lymphadenopathy classification: Difference between revisions
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{{Lymphadenopathy}} | {{Lymphadenopathy}} | ||
{{CMG}}; {{AE}}{{ADS}}, {{RT}}{{DYM}} | {{CMG}}; {{AE}}{{ADS}}, {{RT}}{{DYM}} [[Ogechukwu Hannah Nnabude, MD]] | ||
==Overview== | ==Overview== | ||
[[Lymphadenopathy]] may be classified according to distribution into 2 groups localized [[lymphadenopathy]] and generalized lymphadenopathy. | [[Lymphadenopathy]] may be classified according to distribution into 2 groups localized [[lymphadenopathy]] and generalized lymphadenopathy. | ||
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[[Lymphadenopathy]] may be classified as follows: | [[Lymphadenopathy]] may be classified as follows: | ||
*''' | *'''Location''': | ||
**[[Tracheobronchial]] [[lymph nodes]]. | **[[Tracheobronchial]] [[lymph nodes]]. | ||
**[[Mediastinal]] [[lymphadenopathy]] | **[[Mediastinal]] [[lymphadenopathy]] | ||
**Bilateral [[hilar]] [[lymphadenopathy]] | **Bilateral [[hilar]] [[lymphadenopathy]] | ||
*'''[[Dermatopathic]] [[lymphadenopathy]]''': [[lymphadenopathy]] associated with skin disease. | *'''[[Dermatopathic]] [[lymphadenopathy]]''': [[lymphadenopathy]] associated with skin disease. | ||
*''' | *'''[[Malignancy]]''': [[Benign]] [[lymphadenopathy]] is distinguished from malignant types which mainly refer to [[lymphomas]] or lymph node [[metastasis]]. | ||
*''' | *'''Extent''': | ||
** [[Localized lymphadenopathy]]: due to localized spot of [[infection]] | ** [[Localized lymphadenopathy]]: due to localized spot of [[infection]] | ||
** [[Generalized]] [[lymphadenopathy]]: due to systemic infection of the body. In some cases, it may persist for prolonged periods possibly without an apparent cause | ** [[Generalized]] [[lymphadenopathy]]: due to systemic infection of the body. In some cases, it may persist for prolonged periods possibly without an apparent cause | ||
*''' | *'''Size''', where [[lymphadenopathy]] in adults is often defined as a short axis of one or more [[lymph nodes]] is greater than 10mm.<ref name="pmid20080453">{{cite journal |vauthors=Ganeshalingam S, Koh DM |title=Nodal staging |journal=Cancer Imaging |volume=9 |issue= |pages=104–11 |date=December 2009 |pmid=20080453 |pmc=2821588 |doi=10.1102/1470-7330.2009.0017 |url=}}</ref><ref name="pmid17724531">{{cite journal |vauthors=Schmidt AF, Rodrigues OR, Matheus RS, Kim Jdu U, Jatene FB |title=Mediastinal lymph node distribution, size and number: definitions based on an anatomical study |journal=J Bras Pneumol |volume=33 |issue=2 |pages=134–40 |date=2007 |pmid=17724531 |doi=10.1590/s1806-37132007000200006 |url=}}</ref> | ||
{|class="wikitable" | {|class="wikitable" | ||
|+cutoff (value)|Upper limit of [[lymph node]] sizes in adults | |+cutoff (value)|Upper limit of [[lymph node]] sizes in adults | ||
Latest revision as of 05:12, 9 December 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2], Raviteja Guddeti, M.B.B.S. [3]Delband Yekta Moazami, M.D.[4] Ogechukwu Hannah Nnabude, MD
Overview
Lymphadenopathy may be classified according to distribution into 2 groups localized lymphadenopathy and generalized lymphadenopathy.
Classification
Depending upon the involvement of the lymph nodes, lymphadenopathy is classified into 2 groups, generalized and localized:[1]
- Localized lymphadenopathy: localized adenopathy occurs in contiguous groupings of lymph nodes. In discrete anatomical regions, lymph nodes are distributed, and their enlargement represents their location's lymphatic drainage. Tender or non-tender, fixed or mobile, and discreet or "matted" together can be the nodes themselves. 75 percent of all lymphadenopathies are localized, with over 50% seen in the region of the head and neck.
- Generalized lymphadenopathy: generalized lymphadenopathy involves lymphadenopathy in 2 or more non-contiguous sites. due to generalized infection all over the body e.g. influenza.
- Persistent generalized lymphadenopathy (PGL): persisting for a long time, possibly without an apparent cause.
- Dermatopathic lymphadenopathy: lymphadenopathy associated with skin disease. Tangier disease (ABCA1 deficiency) may also cause this.
Lymphadenopathy may be classified as follows:
- Location:
- Dermatopathic lymphadenopathy: lymphadenopathy associated with skin disease.
- Malignancy: Benign lymphadenopathy is distinguished from malignant types which mainly refer to lymphomas or lymph node metastasis.
- Extent:
- Localized lymphadenopathy: due to localized spot of infection
- Generalized lymphadenopathy: due to systemic infection of the body. In some cases, it may persist for prolonged periods possibly without an apparent cause
- Size, where lymphadenopathy in adults is often defined as a short axis of one or more lymph nodes is greater than 10mm.[2][3]
| Generally | 10 mm[4][5] |
| Inguinal | 10[6] – 20 mm[7] |
| Pelvis | 10 mm for ovoid lymph nodes, 8 mm for rounded[6] |
| Neck | |
|---|---|
| Generally (non-retropharyngeal) | 10 mm[6][8] |
| Jugulodigastric lymph nodes | 11mm[6] or 15 mm[8] |
| Retropharyngeal | 8 mm[8]
|
| Mediastinum | |
| Mediastinum, generally | 10 mm[6] |
| Superior mediastinum and high paratracheal | 7mm[9] |
| Low paratracheal and subcarinal | 11 mm[9] |
| Upper abdominal | |
| Retrocrural space | 6 mm[10] |
| Paracardiac | 8 mm[10] |
| Gastrohepatic ligament | 8 mm[10] |
| Upper paraaortic region | 9 mm[10] |
| Portacaval space | 10 mm[10] |
| Porta hepatis | 7 mm[10] |
| Lower paraaortic region | 11 mm[10] |
References
- ↑ Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A (2014). "Peripheral lymphadenopathy: approach and diagnostic tools". Iran J Med Sci. 39 (2 Suppl): 158–70. PMC 3993046. PMID 24753638.
- ↑ Ganeshalingam S, Koh DM (December 2009). "Nodal staging". Cancer Imaging. 9: 104–11. doi:10.1102/1470-7330.2009.0017. PMC 2821588. PMID 20080453.
- ↑ Schmidt AF, Rodrigues OR, Matheus RS, Kim Jdu U, Jatene FB (2007). "Mediastinal lymph node distribution, size and number: definitions based on an anatomical study". J Bras Pneumol. 33 (2): 134–40. doi:10.1590/s1806-37132007000200006. PMID 17724531.
- ↑ Ganeshalingam, Skandadas; Koh, Dow-Mu (2009). "Nodal staging". Cancer Imaging. 9 (1): 104–111. doi:10.1102/1470-7330.2009.0017. ISSN 1470-7330. PMC 2821588. PMID 20080453.
- ↑ Schmidt Júnior, Aurelino Fernandes; Rodrigues, Olavo Ribeiro; Matheus, Roberto Storte; Kim, Jorge Du Ub; Jatene, Fábio Biscegli (2007). "Distribuição, tamanho e número dos linfonodos mediastinais: definições por meio de estudo anatômico". Jornal Brasileiro de Pneumologia. 33 (2): 134–140. doi:10.1590/S1806-37132007000200006. ISSN 1806-3713. PMID 17724531.
- ↑ 6.0 6.1 6.2 6.3 6.4 6.5 Torabi M, Aquino SL, Harisinghani MG (September 2004). "Current concepts in lymph node imaging". Journal of Nuclear Medicine. 45 (9): 1509–18. PMID 15347718.
- ↑ "Assessment of lymphadenopathy". BMJ Best Practice. Retrieved 2017-03-04. Last updated: Last updated: Feb 16, 2017
- ↑ 8.0 8.1 8.2 Page 432 in: Luca Saba (2016). Image Principles, Neck, and the Brain. CRC Press. ISBN 9781482216202.
- ↑ 9.0 9.1 Sharma, Amita; Fidias, Panos; Hayman, L. Anne; Loomis, Susanne L.; Taber, Katherine H.; Aquino, Suzanne L. (2004). "Patterns of Lymphadenopathy in Thoracic Malignancies". RadioGraphics. 24 (2): 419–434. doi:10.1148/rg.242035075. ISSN 0271-5333. PMID 15026591.
- ↑ 10.0 10.1 10.2 10.3 10.4 10.5 10.6 Dorfman, R E; Alpern, M B; Gross, B H; Sandler, M A (1991). "Upper abdominal lymph nodes: criteria for normal size determined with CT". Radiology. 180 (2): 319–322. doi:10.1148/radiology.180.2.2068292. ISSN 0033-8419. PMID 2068292.