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==[[Lymphadenopathy differential diagnosis|Differentiating Lymphadenopathy from other Diseases]]==
==[[Lymphadenopathy differential diagnosis|Differentiating Lymphadenopathy from other Diseases]]==
==Epidemiology and Demographics==


=Laboratory Evaluation of Lymphadenopathy=
=Laboratory Evaluation of Lymphadenopathy=
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*'''EBV serology''': Epstein-Barr viral mono is present causing regionalized lymphadenopathy
*'''EBV serology''': Epstein-Barr viral mono is present causing regionalized lymphadenopathy
*Sedimentation rate: A measure of inflammation though not diagnostic, it can contribute to diagnostic reasoning
*Sedimentation rate: A measure of inflammation though not diagnostic, can contribute to diagnostic reasoning


*'''Cytomegalovirus titers''': This viral serology is indicative of possible of CMV mononucleosis
*'''Cytomegalovirus titers''': This viral serology is indicative of possible CMV mononucleosis


*'''HIV serology''': This serology can be used to diagnose acute HIV syndrome-related lymphadenopathy or to infer the diagnosis of secondary HIV-elated pathologies causing lymphadenopathy.  
*'''HIV serology''': This serology can be used to diagnose acute HIV syndrome-related lymphadenopathy or to infer the diagnosis of secondary HIV-elated pathologies causing lymphadenopathy.  

Revision as of 14:16, 31 January 2021

Lymphadenopathy


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],Shyam Patel [2];Associate Editor(s)-in-Chief: Amandeep Singh M.D.[3], Raviteja Guddeti, M.B.B.S. [4] Ogechukwu Hannah Nnabude, MD


Synonyms and keywords: Lymph nodes enlarged; Enlarged lymph nodes; Lymphadenitis; Swollen lymph nodes; Swollen/enlarged lymph nodes
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Overview

Classification

Pathophysiology

Histopathology

Causes

Differentiating Lymphadenopathy from other Diseases

Epidemiology and Demographics

Laboratory Evaluation of Lymphadenopathy

  • CBC with manual differential: This is a foundational test in the diagnosis of both generalized and regional lymphadenopathy. The number and differential of the white blood cells can indicate bacterial, viral, or fungal pathology. In addition, characteristic white blood cell (WBC) patterns are observed with several of the hematological neoplasms producing lymphadenopathy
  • EBV serology: Epstein-Barr viral mono is present causing regionalized lymphadenopathy
  • Sedimentation rate: A measure of inflammation though not diagnostic, can contribute to diagnostic reasoning
  • Cytomegalovirus titers: This viral serology is indicative of possible CMV mononucleosis
  • HIV serology: This serology can be used to diagnose acute HIV syndrome-related lymphadenopathy or to infer the diagnosis of secondary HIV-elated pathologies causing lymphadenopathy.
  • Bartonella henselae serology: used for the diagnosis of cat-scratch lymphadenopathy
  • FTA\RPR: These tests can diagnose syphilis as the cause of lymphadenopathy
  • Herpes simplex serology: can determine if the lymphadenopathy is herpes-related. Herpes simplex can produce symptoms that are similar to mononucleosis.
  • Toxoplasmosis serology: can be used to diagnose toxoplasmosis
  • Hepatitis B serology: Serological tests for hepatitis B to establish it as a contributing factor for lymphadenopathy
  • ANA: this is a screening test for SLE that can help establish it as a cause for generalized lymphadenopathy

Diagnostic Radiological Testing

  • Chest x-ray: can reveal tuberculosis, pulmonary sarcoidosis, and pulmonary neoplasm.
  • Chest CT scan: This modality of radiological imaging can define the above processes and reveal hilar adenopathy.
  • Abdominal and pelvic CT scan: These images, in combination with chest CT scan, can be revealed in cases of supraclavicular adenopathy and the diagnosis of secondary neoplasm.
  • Ultrasonography: can be used in the assessment of number, size, size, shape, the marginal definition, and internal structures in patients with lymphadenopathy. Color Doppler ultrasonography is of use in distinguishing the vascular pattern between more established, pre-existing lymphadenopathy and acute lymphadenopathy. Studies have indicated that a low long axis to short axis ratio of lymphadenopathy as measured by ultrasound can be a significant indicator of lymphoma and metastatic cancer as a cause of lymphadenopathy.
  • MRI scanning: useful in the evaluation of thoracic, abdominal, and pelvic masses.
  • PPD: can be used in the diagnosis of tuberculosis
  • Tissue diagnosis of the node: this is done by incisional biopsy and remains the gold standard for diagnosis of lymphadenopathy.

Treatment

Treatment of lymphadenopathy is based on the etiology. Generally, treatment of lymphadenopathy is as follows:

  • Infectious causes of lymphadenopathy can be treated with antibiotic therapy, antiviral therapy, or antifungal therapy.
  • Immune therapy, systemic glucocorticoids can be used for autoimmune causes of lymphadenopathy
  • For malignancies, any combination of surgery, chemotherapy, and radiation therapy can be used.
  • If medication is the suspected cause, discontinue the medication if possible.

References



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