Lymphadenopathy is defined as lymph nodes that are abnormal in size (>1 cm), consistency or number.
The extent of lymphadenopathy is defined as localized when it involves only one region, and generalized when it involves more than one region.
Lymphadenopathy is commonly encountered by physicians in clinical practice and requires a comprehensive evaluation.
When initiating a workup, the physician should pay close attention to the size, location, consistency and number of enlarged lymph nodes, as well as to the patient's age, duration of lymphadenopathy, exposures, and any associated symptoms.
Etiologies of lymphadenopathy can include infection, cancer, autoimmune conditions, granulomatous disease, collagen vascular disease, and atypical lymphoproliferative disorders. While the cause of lymphadenopathy is often apparent after a careful history and physical exam, further testing may be required and may include investigation with microbiologic and serologic tests, imaging and/or biopsy.
- Infectious mononucleosis (Epstein-Barr virus)
- Cytomegalovirus (CMV)
- Herpes zoster (shingles)
- Streptococcal pharyngitis
- 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)
- Hepatitis B
- Hepatitis C
- Cat scratch disease
- Tuberculosis (TB)
- Mycobacterium avium-intracellulare (MAI)
- Rocky Mountain spotted fever
- Lymphogranuloma venereum (LGV)
- Systemic lupus erythematosus (SLE)
- Rheumatoid arthritis
- Sjogren syndrome
- Crohn disease
- Kawasaki disease
- 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)
- Genital herpes
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