DIFFERENTIAL

DIAGNOSIS OF

CERVICAL

LYMPHADENOPATHY

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, Sjogren’s syndrome

Causes of cervical lymphadenopathy contd.

3. Malignant diseases: Hematologic: Hodgkins/Non-Hodgkins, T-cell lymphomaSecondary: metastasis, Virchow’s node

4. Lipid storage diseases Gauchers disease

5. Endocrine diseases Hyperthyroidism, Adrenal insufficiency, Thyroiditis

6. Miscellaneous Sarcoidosis, Kawasaki’s diseases, Castleman’s disease

DDX of Cervical Lymphadenopathy

Viral

• Infectious Mononucleosis – EBV

• Cytomegalovirus

• Initial stages of HIV infection

• Measles

• Rubella

Bacterial

• Cat-scratch disease

• Pharyngitis due to Group A

Streptococcus

• Tuberculous lymphadenitis

(Scrofula)

• Tularemia

• 2° Syphillis

Malignancies

• Lymphoma

Miscellaneous

• 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

THANK YOU