Evaluation of lymphadenopathy

Last reviewed: 10 Apr 2025
Last updated: 21 Mar 2025

Summary

Differentials

Common

  • Infectious mononucleosis (Epstein-Barr virus)
  • HIV
  • Adenovirus
  • Cytomegalovirus (CMV)
  • Herpes zoster (shingles)
  • Streptococcal pharyngitis
Full details

Uncommon

  • Non-Hodgkin lymphoma
  • Hodgkin lymphoma
  • Metastatic solid tumor
  • Drug-associated lymphadenopathy
  • Serum sickness
  • Graft-versus-host disease (GVHD)
  • Human T-lymphotropic virus 1 (HTLV-1)
  • Mumps
  • Measles
  • Hepatitis B
  • Hepatitis C
  • Cat scratch disease
  • Tuberculosis (TB)
  • Leprosy
  • Mycobacterium avium-intracellulare (MAI)
  • Syphilis
  • Tularemia
  • Brucellosis
  • Rocky Mountain spotted fever
  • Histoplasmosis
  • Coccidioidomycosis
  • Cryptococcosis
  • Lymphogranuloma venereum (LGV)
  • Toxoplasmosis
  • Leishmaniasis
  • Systemic lupus erythematosus (SLE)
  • Rheumatoid arthritis
  • Dermatomyositis
  • Sjogren syndrome
  • Sarcoidosis
  • Crohn disease
  • Kawasaki disease (KD)
  • Castleman disease (angiofollicular lymph node hyperplasia)
  • Kikuchi disease (histiocytic necrotizing lymphadenitis)
  • Inflammatory pseudotumor
  • Progressive transformation of germinal centers
  • Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy)
  • Rubella
  • Genital herpes
  • Chancroid
  • Leptospirosis
  • Silicosis
  • IgG4-related disease
  • Mpox
Full details

Contributors

Authors

Jennie Y. Law, MD

Associate Professor of Medicine

Division of Hematology/Oncology

Department of Medicine

University of Maryland School of Medicine

Baltimore, MD USA

Disclosures

JYL declares that she has no competing interests.

Acknowledgements

Dr Jennie Y. Law would like to gratefully acknowledge Dr Michael E. Bromberg and Dr Efrat Dotan, previous contributors to this topic. MB and ED declare that they have no competing interests.

Peer reviewers

Daniel Hodson, BM BCh

Principal Investigator, Medical Research Council Clinician Scientist

Honorary Consultant Haematologist

Wellcome-MRC Cambridge Stem Cell Institute

University of Cambridge, Department of Haematology

The Jeffrey Cheah Biomedical Centre

Cambridge Biomedical Campus

Cambridge

UK

Disclosures

DH has received a research funding scholarship from Gilead Sciences.

Paneesha Shankaranarayana, MBBS

Consultant Hematologist

Heartlands Hospital

Birmingham

UK

Disclosures

PS declares that she has no competing interests.

Rebecca Connor, MD

Chief Fellow

Section of Hematology and Oncology

Department of Internal Medicine

Wake Forest University Baptist Medical Center

Winston-Salem

NC

Disclosures

RC declares that she has no competing interests.

Han Myint, MD, FRCP, FRCPath

Professor of Medicine

Director

Hematology Malignancies and Blood & Marrow Transplant Program

University of Colorado at Denver and Health Sciences Center

Denver

CO

Disclosures

HM declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Habermann TM, Steensma DP. Lymphadenopathy. Mayo Clin Proc. 2000 Jul;75(7):723-32. Abstract

Brown JR, Skarin AT. Clinical mimics of lymphoma. Oncologist. 2004;9(4):406-16.Full text  Abstract

Pynnonen MA, Gillespie MB, Roman B, et al. Clinical practice guideline: evaluation of the neck mass in adults. Otolaryngol Head Neck Surg. 2017 Sep;157(suppl 2):S1-30.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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