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[lymph- + adenopathy]
Enlargement of lymph nodes (LN), typically to greater than 1.5 cm. The increased size is caused by activation and proliferation of lymphocytes and phagocytic white blood cells within the node or by invasion of the node by tumor. Most often, lymphadenopathy is found in nodes involved in local, regional, or systemic infections; it results occasionally from cancers. Lymphadenopathy may also be found in an array of other, less common illnesses, including thyroiditis, thyrotoxicosis, autoimmune diseases, e.g., rheumatoid arthritis, sarcoidosis, and drug reactions, e.g., phenytoin.
CERVICAL LYMPHADENOPATHY Squamous cell carcinoma of the neck
Enlarged LNs may be tender or not; tenderness often is present when lymph nodes swell rapidly, e.g., in response to infections, hypersensitivity reactions, or some fulminant lymphomas. Rock-hard, enlarged, and immobile LNs are typical of metastatic cancer, whereas rubbery LNs are found in lymphomas. LNs that do not resolve spontaneously within 4 to 6 weeks, or for which no obvious explanation exists, usually are sampled by biopsy or aspiration.
SEE TABLE: Causes of Swollen Glands
Causes of Swollen Glands
|Category||Examples||Location||Age of patient||Texture||Size||Associated signs or symptoms||Diagnostic tests||Necessity for biopsy or aspirate|
|Bacterial infection||Strep throat; cat scratch disease||Angle of the jaw; axilla, neck||Child or preteen; any||Relatively soft and tender; relatively soft and tender||1 sq. cm;>1 cm||Fever, sore throat, tonsillar exudate, malaise, headache, difficulty swallowing; may have fever, night sweats, weight loss||Can be diagnosed clinically; antibody blood tests||No; not usually|
|Granuloma||Tuberculosis; sarcoidosis||Neck, chest; hilum of the lung and other locations||Any; usually adults||Relatively soft and tender; rubbery||>1 cm;>1 cm, sometimes massive||May have fever, night sweats, weight loss, productive sputum; cough, shortness of breath, may have systemic illness, or be asymptomatic||Tuberculin (purified protein derivative), interferon blood test, sputum for acid-fast bacilli; blood for ACE levels||Occasionally; often|
|Metastatic cancer||Breast cancer||Axilla next to the breast||Adults||Rock hard||Especially likely if>2 cm||Lump in the breast||Mammography, ultrasound, other imaging techniques||Yes|
|Lymphoma||Hodgkin lymphoma||Chest, neck, axilla, groin, or all of these||Young adult||Rubbery||>1 cm||May have fever, night sweats, weight loss, enlarged spleen||Radiologic imaging||Yes|
|Viral infection||Mononucleosis; HIV/AIDS||Head and neck, spleen; generalized||Young adult; any, but most often young adult or adult||Rubbery; firm||About 1 cm; variable||May have fever, night sweats, weight loss; fever, night sweats, weight loss, or symptoms of opportunistic infection||Tests for Epstein-Barr virus, heterophile antibody; antibody blood tests||No; not usually|