What is the definition of lymphadenopathy??

Lymphadenopathy is defined as being an abnormal increase in size and/or an alteration in consistency of lymph nodes that presents as swollen or enlarged lymph nodes.

How does lymphadenopathy occur?

Lymph nodes are a major part of the immune system as they produce antibodies & lymphocytes that play a role in combatting infection. When an infection is present, the lymph nodes produce larger amounts of lymphocytes lymph nodes swell, become enlarged and painful

So what is cervical lymphadenopathy?

Cervical lymphadenopathy is the enlargement of the lymph nodes present in the cervical area enlargement of the cervical lymph nodes greater than 1cm in diameter (normal lymph nodes are < 1cm) It is a common manifestation in the course of many diseases

Causes of cervical lymphadenopathy

1. Infections

2. Immunological diseases RA, SLE, Sjogrens syndrome

Causes of cervical lymphadenopathy contd.

3. Malignant diseases: Hematologic: Hodgkins/Non-Hodgkins, T-cell lymphoma Secondary: metastasis, Virchows node
4. Lipid storage diseases Gauchers disease 5. Endocrine diseases Hyperthyroidism, Adrenal insufficiency, Thyroiditis 6. Miscellaneous Sarcoidosis, Kawasakis diseases, Castlemans disease

DDX of Cervical Lymphadenopathy

Viral
Infectious Mononucleosis EBV Cytomegalovirus Initial stages of HIV infection Measles Rubella Bacterial

Tuberculous lymphadenitis (Scrofula)

Tularemia 2 Syphillis Malignancies Lymphoma Miscellaneous

Cat-scratch disease
Pharyngitis due to Group A Streptococcus

Sarcoidosis

EBV Infectious Mononucleosis

Tularemic cervical lymphadenopathy

Cat-scratch disease

Bilateral lymph node englargement - Nasopharyngeal carcinoma

TUBERCULOUS LYMPHADENITIS Scrofula

How do you manage cervical lymphadenopathy?

Treatment of cervical lymphadenopathy is dependent on the underlying etiological cause Most physicians will treat children with cervical lymphadenopathy conservatively

Antibiotics should only be given if a bacterial infection is suspected

Patients should immediately consult a doctor if the nodes further increase in size In the presence of lymphadenitis aspirate may be necessary for culture and removal of the affected lymph node maybe indicated

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