Lymphadenopathy natural history, complications and prognosis

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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]

Overview

The natural course of lymphadenopathy depends on the underlying cause. Lymphadenopathy due to infectious causes subsides once the infection is controlled. Common complications of lymphadenopathy depends on the site of involvement, e.g. mediastinal lymphadenopathy include compression symptoms likeTracheal and bronchial obstruction and Dysphagia in Superior vena cava syndrome. Prognosis is generally excellent for infectious causes. Prompt treatment with antibiotics usually leads to a complete recovery. However, it may take weeks, or even months, for swelling to disappear. The amount of time to recovery depends on the cause. Prognosis is poor for malignant tumors.

Natural History

The natural course of lymphadenopathy depends on the underlying cause. Lymphadenopathy due to infectious causes subsides once the infection is controlled.

Natural History, Complications and Prognosis

• Patients with lymphadenopathy may be symptomatic or asymptomatic, depending on the aetiology.
• Early clinical features include palpable tenderness, pain, and fever.

• Common complications of lymphadenopathy, include:

Mediastinal lymphadenopathy

• Superior vena cava syndrome
  • Tracheal and bronchial obstruction
  • Dysphagia
  • Hemoptysis
• Uric acid nephropathy
• Hyperkalemia
• Hypercalcemia
• Hypocalcemia
• Hyperphosphatemia
• Renal failure

Abdominal lymphadenopathy

• Intestinal obstruction

Superficial lymphadenopathy

• Abscess formation
• Cellulitis
• Fistulas (seen in lymphadenitis that is due to tuberculosis)
• Sepsis

Complications

• Mediastinal lymphadenopathy causes pressure symptoms like:
  • Superior vena cava syndrome
  • Tracheal and bronchial obstruction
  • Dysphagia
  • Hemoptysis
• Uric acid nephropathy
• Hyperkalemia
• Hypercalcemia
• Hypocalcemia
• Hyperphosphatemia
• Renal failure
• Abdominal lymphadenopathy can cause
  • Abdominal pain
  • Intestinal obstruction
• Superficial lymphadenopathy can cause
  • Abscess formation
  • Cellulitis (a skin infection)
  • Fistulas (seen in lymphadenitis that is due to tuberculosis)
  • Sepsis (bloodstream infection)

Prognosis

Prompt treatment with antibiotics usually leads to a complete recovery. However, it may take weeks, or even months, for swelling to disappear. The amount of time to recovery depends on the cause. Prognosis is poor for malignant tumors.