Ī Dutch study also revealed that of 2556 patients that presented with unclear lymphadenopathy to their family physicians, 10% were referred for a biopsy, and only 1.1% were found to be related to malignancy. Of these patients, no one was found to have a debilitating illness. Īdults also appear to have a low prevalence of malignancy. To further characterize this, a study was completed in a family practice setting where only 3% of 249 patients with lymphadenopathy underwent biopsies. reviewed 239 children who underwent a peripheral node biopsy and found that the most common etiology noted was reactive hyperplasia of unknown etiology, followed by granulomatous infections, cancer, and dermatopathic lymphadenopathy. Age is an important factor in characterizing the epidemiology of lymphadenopathy, and thus, can be divided into children and adults.Ĭhildren more commonly appear to have benign causes of lymphadenopathy. To better understand this, a study completed by Knight PJ et al. Lastly, inguinal lymphadenopathy can be impacted by local sexually transmitted infections, lymphoma, and pelvic malignancies.Ī majority of patients with lymphadenopathy will have a benign etiology.

Axillary lymphadenopathy can also be related to lymphoma or breast malignancy but can be involved by infections such as cat-scratch disease. Posterior cervical lymphadenopathy can arise from localized bacterial and viral infections, as well as lymphoma. Submental and submandibular lymphadenopathy commonly is infectious in origin, often presenting with viral prodromes. A thorough history and physical exam are one of the most important steps in determining the underlying cause of lymphadenopathy.Įtiologies can be determined based on lymph node groups. Įlucidating the etiology of lymphadenopathy can be challenging. Generalized lymphadenopathy, which involves two or more non-contiguous regions, is reported to occur in 25% of lymphadenopathies.

About 75% of most lymphadenopathies are localized, and about 50% of those occur in the head and neck regions. Lymphadenopathy can be localized or diffuse. Lymphoproliferative disorders such as hemophagocytic lymphohistiocytosis can also manifest with the enlargement of lymph nodes. Malignant diseases like lymphoma, leukemia, metastatic cancer, and head and neck cancers are also common causes of lymphadenopathy. Autoimmune disorders that may contribute include but are not limited to sarcoidosis, amyloidosis, systemic lupus erythematosus, rheumatoid arthritis, and eosinophilic granulomatosis with polyangiitis. There is a wide range of infectious etiologies, including bacterial, fungal, viral, mycobacterial, spirochetal, and protozoal organisms. There are several potential causes of lymphadenopathy, ranging from infectious, autoimmune, malignant, and lymphoproliferative. Lymphadenopathy, while pertinent, may be nonspecific. In general, the size of a normal lymph node in the adult population should be less than 1 cm however, there are exceptions to this rule.

When inspecting for lymphadenopathy, one should carefully examine all pertinent anatomic regions, including the neck, supraclavicular, axillary, and inguinal regions. They are divided into sections known as follicles, which are subdivided into B zones and T zones, which represent the base location of lymphocytic maturation.Ībnormal proliferation of lymphocytes may be a result of inflammation, infection, or malignancy, and thus, clinicians must perform a detailed history and physical to screen for lymphadenopathy. Lymph nodes are small glands that are responsible for filtering fluid from the lymphatic system. Lymphadenopathy is a term that refers to the swelling of lymph nodes. Lymphocytes are the integral agents involved in searching for target proteins and travel through lymph nodes, which are diffusely placed throughout the body. The lymphatic system is a complex component of the immune system involved in filtering substances in the body.

Back of neck swollen lymph nodes