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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.
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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
CategoryExamplesLocationAge of patientTextureSizeAssociated signs or symptomsDiagnostic testsNecessity for biopsy or aspirate
Bacterial infectionStrep throat; cat scratch diseaseAngle of the jaw; axilla, neckChild or preteen; anyRelatively soft and tender; relatively soft and tender1 sq. cm; >1 cmFever, sore throat, tonsillar exudate, malaise, headache, difficulty swallowing; may have fever, night sweats, weight lossCan be diagnosed clinically; antibody blood testsNo; not usually
GranulomaTuberculosis; sarcoidosisNeck, chest; hilum of the lung and other locationsAny; usually adultsRelatively soft and tender; rubbery>1 cm; >1 cm, sometimes massiveMay have fever, night sweats, weight loss, productive sputum; cough, shortness of breath, may have systemic illness, or be asymptomaticTuberculin (purified protein derivative), interferon blood test, sputum for acid-fast bacilli; blood for ACE levelsOccasionally; often
Metastatic cancerBreast cancerAxilla next to the breastAdultsRock hardEspecially likely if >2 cmLump in the breastMammography, ultrasound, other imaging techniquesYes
LymphomaHodgkin lymphomaChest, neck, axilla, groin, or all of theseYoung adultRubbery>1 cmMay have fever, night sweats, weight loss, enlarged spleenRadiologic imagingYes
Viral infectionMononucleosis; HIV/AIDSHead and neck, spleen; generalizedYoung adult; any, but most often young adult or adultRubbery; firmAbout 1 cm; variableMay have fever, night sweats, weight loss; fever, night sweats, weight loss, or symptoms of opportunistic infectionTests for Epstein-Barr virus, heterophile antibody; antibody blood testsNo; not usually

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