Lymphadenopathy: Difference between revisions

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:*[[Upper respiratory tract infection]]
:*[[Upper respiratory tract infection]]
:*Foreign travel
:*Foreign travel




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===Imaging Findings===
===Imaging Findings===
'''Ultrasonography'''
'''Ultrasonography'''
*On ultrasound, characteristic findings of lymphadenopathy, include:<ref name="pmid24753638">{{cite journal |vauthors=Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A |title=Peripheral lymphadenopathy: approach and diagnostic tools |journal=Iran J Med Sci |volume=39 |issue=2 Suppl |pages=158–70 |year=2014 |pmid=24753638 |pmc=3993046 |doi= |url=}}</ref><ref name="radio">Lymph node enlargment. Radiopedia.  http://radiopaedia.org/articles/lymph-node-enlargement Accessed on May 9, 2016 </ref><ref name="AA">Lymph node enlargment. Wikipedia. https://en.wikipedia.org/wiki/Lymph_node Accessed on May 9, 2016</ref>
*On ultrasound, characteristic findings of lymphadenopathy, include:<ref name="pmid24753638">{{cite journal |vauthors=Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A |title=Peripheral lymphadenopathy: approach and diagnostic tools |journal=Iran J Med Sci |volume=39 |issue=2 Suppl |pages=158–70 |year=2014 |pmid=24753638 |pmc=3993046 |doi= |url=}}</ref><ref name="radio">Lymph node enlargment. Radiopedia.  http://radiopaedia.org/articles/lymph-node-enlargement Accessed on May 9, 2016 </ref>
:*Increased lymph node size  
:*Increased lymph node size  
'''CT'''
'''CT'''
*On CT, characteristic findings of lymphadenopathy, include:<ref name="pmid24753638">{{cite journal |vauthors=Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A |title=Peripheral lymphadenopathy: approach and diagnostic tools |journal=Iran J Med Sci |volume=39 |issue=2 Suppl |pages=158–70 |year=2014 |pmid=24753638 |pmc=3993046 |doi= |url=}}</ref><ref name="radio">Lymph node enlargment. Radiopedia.  http://radiopaedia.org/articles/lymph-node-enlargement Accessed on May 9, 2016 </ref><ref name="AA">Lymph node enlargment. Wikipedia. https://en.wikipedia.org/wiki/Lymph_node Accessed on May 9, 2016</ref><ref name="pmid10670052">{{cite journal |vauthors=van den Brekel MW, Castelijns JA |title=Imaging of lymph nodes in the neck |journal=Semin Roentgenol |volume=35 |issue=1 |pages=42–53 |date=January 2000 |pmid=10670052 |doi= |url=}}</ref><ref name="pmid11264102">{{cite journal |vauthors=Sumi M, Ohki M, Nakamura T |title=Comparison of sonography and CT for differentiating benign from malignant cervical lymph nodes in patients with squamous cell carcinoma of the head and neck |journal=AJR Am J Roentgenol |volume=176 |issue=4 |pages=1019–24 |date=April 2001 |pmid=11264102 |doi=10.2214/ajr.176.4.1761019 |url=}}</ref>
*On CT, characteristic findings of lymphadenopathy, include:<ref name="pmid24753638">{{cite journal |vauthors=Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A |title=Peripheral lymphadenopathy: approach and diagnostic tools |journal=Iran J Med Sci |volume=39 |issue=2 Suppl |pages=158–70 |year=2014 |pmid=24753638 |pmc=3993046 |doi= |url=}}</ref><ref name="radio">Lymph node enlargment. Radiopedia.  http://radiopaedia.org/articles/lymph-node-enlargement Accessed on May 9, 2016 </ref><ref name="pmid10670052">{{cite journal |vauthors=van den Brekel MW, Castelijns JA |title=Imaging of lymph nodes in the neck |journal=Semin Roentgenol |volume=35 |issue=1 |pages=42–53 |date=January 2000 |pmid=10670052 |doi= |url=}}</ref><ref name="pmid11264102">{{cite journal |vauthors=Sumi M, Ohki M, Nakamura T |title=Comparison of sonography and CT for differentiating benign from malignant cervical lymph nodes in patients with squamous cell carcinoma of the head and neck |journal=AJR Am J Roentgenol |volume=176 |issue=4 |pages=1019–24 |date=April 2001 |pmid=11264102 |doi=10.2214/ajr.176.4.1761019 |url=}}</ref>


:*Most nodes: 10 mm in short-axis
:*Most nodes: 10 mm in short-axis
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== Treatment ==
== Treatment ==
*There is no treatment for lymphadenopathy; the mainstay of therapy is treating the underlying condition.<ref name="pmid24753638">{{cite journal |vauthors=Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A |title=Peripheral lymphadenopathy: approach and diagnostic tools |journal=Iran J Med Sci |volume=39 |issue=2 Suppl |pages=158–70 |year=2014 |pmid=24753638 |pmc=3993046 |doi= |url=}}</ref>  
*There is no treatment for lymphadenopathy; the mainstay of therapy is treating the underlying condition.<ref name="pmid24753638">{{cite journal |vauthors=Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A |title=Peripheral lymphadenopathy: approach and diagnostic tools |journal=Iran J Med Sci |volume=39 |issue=2 Suppl |pages=158–70 |year=2014 |pmid=24753638 |pmc=3993046 |doi= |url=}}</ref>  
**Infectious lymphadenopathy responds well to prompt treatment with antibiotics, and usually leads to a complete recovery. However, it may take months, for swelling to disappear. The amount of time to recovery depends on the cause.<ref name="AA">Lymph node enlargment. Wikipedia. https://en.wikipedia.org/wiki/Lymph_node Accessed on May 9, 2016</ref>
**Infectious lymphadenopathy responds well to prompt treatment with antibiotics, and usually leads to a complete recovery. However, it may take months, for swelling to disappear. The amount of time to recovery depends on the cause.
**Neoplastic (malignant) lymphadenopathy usually responds well to systemic chemotherapy.
**Neoplastic (malignant) lymphadenopathy usually responds well to systemic chemotherapy.



Revision as of 16:55, 23 January 2019

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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]Maria Fernanda Villarreal, M.D. [3] Raviteja Guddeti, M.B.B.S. [4]

Synonyms and keywords: Lymph nodes enlarged; Enlarged lymph nodes; Lymphadenitis; Swollen lymph nodes; Swollen/enlarged lymph nodes
For patient information, click here

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Lymphadenopathy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic criteria | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X-Ray Findings | Echocardiography and Ultrasound | CT-Scan Findings | MRI Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Causes

Differentiating Lymphadenopathy from other Diseases


Risk Factors

  • The most common risk factors in the development of lymphadenopathy, include:


Imaging Findings

Ultrasonography

  • On ultrasound, characteristic findings of lymphadenopathy, include:[2][3]
  • Increased lymph node size

CT

  • On CT, characteristic findings of lymphadenopathy, include:[2][3][4][5]
  • Most nodes: 10 mm in short-axis
  • Sub-mental and sub-mandibular: 15 mm
  • Retropharyngeal: 8 mm
  • Loss of fatty hilum
  • Focal necrosis
  • Cystic necrotic nodes
  • Long-to-short axis ratio (>2cm - usually benign)
  • The upper limit in size of a normal node varies with location.

PET/CT

  • On PET/CT, lymphadenopathy can be further assessed via quantitation of FDG uptake, which is a surrogate of metabolic activity. Infectious, inflammatory, and neoplastic processes will show high FDG avidity on PET/CT. PET/CT is particularly useful for assessing response of lymph nodes to systemic chemotherapy.

MRI

  • MRI is the most anatomically precise test for assessing lymphadenopathy. MRI is particularly useful for intraabdominal lymphadenopathy, which cannot be readily palpated via physical examination. MRI is more expensive than CT scan, so CT is preferred in general unless the clinical need for MRI arises.

Treatment

  • There is no treatment for lymphadenopathy; the mainstay of therapy is treating the underlying condition.[2]
    • Infectious lymphadenopathy responds well to prompt treatment with antibiotics, and usually leads to a complete recovery. However, it may take months, for swelling to disappear. The amount of time to recovery depends on the cause.
    • Neoplastic (malignant) lymphadenopathy usually responds well to systemic chemotherapy.

References

  1. Deschenes J, Seamone CD, Baines MG (1992). "Acquired ocular syphilis: diagnosis and treatment". Ann Ophthalmol. 24 (4): 134–8. PMID 1590633.
  2. 2.0 2.1 2.2 Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A (2014). "Peripheral lymphadenopathy: approach and diagnostic tools". Iran J Med Sci. 39 (2 Suppl): 158–70. PMC 3993046. PMID 24753638.
  3. 3.0 3.1 Lymph node enlargment. Radiopedia. http://radiopaedia.org/articles/lymph-node-enlargement Accessed on May 9, 2016
  4. van den Brekel MW, Castelijns JA (January 2000). "Imaging of lymph nodes in the neck". Semin Roentgenol. 35 (1): 42–53. PMID 10670052.
  5. Sumi M, Ohki M, Nakamura T (April 2001). "Comparison of sonography and CT for differentiating benign from malignant cervical lymph nodes in patients with squamous cell carcinoma of the head and neck". AJR Am J Roentgenol. 176 (4): 1019–24. doi:10.2214/ajr.176.4.1761019. PMID 11264102.



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