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
Jennie Y. Law, MD
Assistant Professor of Medicine
Division of Hematology/Oncology
Department of Medicine
University of Maryland School of Medicine
Baltimore, MD USA
JYL declares that she has no competing interests.
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.
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
DH has received a research funding scholarship from Gilead Sciences.
Paneesha Shankaranarayana, MBBS
PS declares that she has no competing interests.
Rebecca Connor, MD
Section of Hematology and Oncology
Department of Internal Medicine
Wake Forest University Baptist Medical Center
RC declares that she has no competing interests.
Han Myint, MD, FRCP, FRCPath
Professor of Medicine
Hematology Malignancies and Blood & Marrow Transplant Program
University of Colorado at Denver and Health Sciences Center
HM declares that he has no competing interests.
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