Lymphadenopathy

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Lymphadenopathy
Lymphadenopathy
ICD-10 I88, L04, R59.1
ICD-9 289.1-289.3, 683, 785.6
DiseasesDB 22225
MeSH D008206

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List of terms related to Lymphadenopathy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

Synonyms and keywords: Lymph nodes enlarged, enlarged lymph nodes, lymphadenitis

Overview

Lymphadenopathy is a term meaning "disease of the lymph nodes." It is, however, almost synonymously used with "swollen/enlarged lymph nodes".

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.

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:

Pathophysiology

Causes

Differentiating from other diseases

Epidemiology and Demogaphics

Risk factors

Natural history, Complications, Prognosis

Diagnosis

Symptoms

Physical examination

Lab findings

Imaging

Treatment

Lymphadenopathy associated conditions

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:

  • 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.[2]

Diagnosis

Patterns of Benign (Reactive) Lymphadenopathy

There are three distinct patterns of benign lymphadenopathy:

  • Follicular hyperplasia. Seen in infections, autoimmune disorders, and nonspecific reactions.
  • Paracortical hyperplasia. Seen in viral infections, skin diseases, and nonspecific reactions.
  • Sinus histiocytosis. Seen in lymph nodes draining limbs, inflammatory lesions, and malignancies.

Bihilar lymphadenopathy

Bihilar lymphadenopathy is a 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:

Less common causes include:

Physical Examination

Chest X Ray

Diagnostic Findings

(Images courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)

Differential Diagnosis of Causes of Lymphadenopathy

In alphabetical order. [4] [5]

References

  1. 1.0 1.1 1.2 Status and anamnesis, Anders Albinsson. Page 12
  2. Chris Jennings (1993). "Understanding and Preventing AIDS: A Book for Everyone".
  3. http://picasaweb.google.com/mcmumbi/USMLEIIImages
  4. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  5. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X


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