Loading AI tools
Abnormal change in size of the lymph nodes From Wikipedia, the free encyclopedia
Lymphadenopathy or adenopathy is a disease of the lymph nodes, in which they are abnormal in size or consistency. Lymphadenopathy of an inflammatory type (the most common type) is lymphadenitis,[1] producing swollen or enlarged lymph nodes. In clinical practice, the distinction between lymphadenopathy and lymphadenitis is rarely made and the words are usually treated as synonymous. Inflammation of the lymphatic vessels is known as lymphangitis.[2] Infectious lymphadenitis affecting lymph nodes in the neck is often called scrofula.
| Lymphadenopathy | |
|---|---|
| Other names | Adenopathy, swollen lymph nodes, swollen glands |
| |
| A CT scan of axillary lymphadenopathy in a 57-year-old man with multiple myeloma. | |
| Specialty | Infectious disease, oncology |
| Symptoms | Fever; Hard, fixed, rapidly growing nodes, indicating a possible cancer or lymphoma; night sweats; runny nose; sore throat |
| Causes | Infections; autoimmune diseases; malignancies; histiocytoses; storage diseases; benign hyperplasia; drug reactions |
| Risk factors | Back pain; constipation; urinary frequency |
| Diagnostic method | CT scan; MRI scan; ultrasound |
Lymphadenopathy is a common and nonspecific sign. Common causes include infections (from minor causes such as the common cold and post-vaccination swelling to serious ones such as HIV/AIDS), autoimmune diseases, and cancer. Lymphadenopathy is frequently idiopathic and self-limiting.
Lymph node enlargement is recognized as a common sign of infectious, autoimmune, or malignant disease. Examples may include:
Infectious causes of lymphadenopathy may include bacterial infections such as cat scratch disease, tularemia, brucellosis, or prevotella, as well as fungal infections such as paracoccidioidomycosis.[14][15]
Benign lymphadenopathy is a common biopsy finding, and may often be confused with malignant lymphoma. It may be separated into major morphologic patterns, each with its own differential diagnosis with certain types of lymphoma. Most cases of reactive follicular hyperplasia are easy to diagnose, but some cases may be confused with follicular lymphoma. There are seven distinct patterns of benign lymphadenopathy:[6]
These morphological patterns are never pure. Thus, reactive follicular hyperplasia can have a component of paracortical hyperplasia. However, this distinction is important for the differential diagnosis of the cause.
In cervical lymphadenopathy (of the neck), it is routine to perform a throat examination including the use of a mirror and an endoscope.[27]
On ultrasound, B-mode imaging depicts lymph node morphology, whilst power Doppler can assess the vascular pattern.[28] B-mode imaging features that can distinguish metastasis and lymphoma include size, shape, calcification, loss of hilar architecture, as well as intranodal necrosis.[28] Soft tissue edema and nodal matting on B-mode imaging suggests tuberculous cervical lymphadenitis or previous radiation therapy.[28] Serial monitoring of nodal size and vascularity are useful in assessing treatment response.[28]
Fine-needle aspiration cytology (FNAC) has sensitivity and specificity percentages of 81% and 100%, respectively, in the histopathology of malignant cervical lymphadenopathy.[27] PET-CT has proven to be helpful in identifying occult primary carcinomas of the head and neck, especially when applied as a guiding tool prior to panendoscopy, and may induce treatment related clinical decisions in up to 60% of cases.[27]
Lymphadenopathy may be classified by:
| Generally | 10 mm[29][30] |
| Inguinal | 10[31] – 20 mm[32] |
| Pelvis | 10 mm for ovoid lymph nodes, 8 mm for rounded[31] |
| Neck | |
|---|---|
| Generally (non-retropharyngeal) | 10 mm[31][33] |
| Jugulodigastric lymph nodes | 11mm[31] or 15 mm[33] |
| Retropharyngeal | 8 mm[33]
|
| Mediastinum | |
| Mediastinum, generally | 10 mm[31] |
| Superior mediastinum and high paratracheal | 7mm[34] |
| Low paratracheal and subcarinal | 11 mm[34] |
| Upper abdominal | |
| Retrocrural space | 6 mm[35] |
| Paracardiac | 8 mm[35] |
| Gastrohepatic ligament | 8 mm[35] |
| Upper paraaortic region | 9 mm[35] |
| Portacaval space | 10 mm[35] |
| Porta hepatis | 7 mm[35] |
| Lower paraaortic region | 11 mm[35] |
Lymphadenopathy of the axillary lymph nodes can be defined as solid nodes measuring more than 15 mm without fatty hilum.[36] Axillary lymph nodes may be normal up to 30 mm if consisting largely of fat.[36]
In children, a short axis of 8 mm can be used.[37] However, inguinal lymph nodes of up to 15 mm and cervical lymph nodes of up to 20 mm are generally normal in children up to age 8–12.[38]
Lymphadenopathy of more than 1.5–2 cm increases the risk of cancer or granulomatous disease as the cause rather than only inflammation or infection. Still, an increasing size and persistence over time are more indicative of cancer.[39]
Seamless Wikipedia browsing. On steroids.
Every time you click a link to Wikipedia, Wiktionary or Wikiquote in your browser's search results, it will show the modern Wikiwand interface.
Wikiwand extension is a five stars, simple, with minimum permission required to keep your browsing private, safe and transparent.
