HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Take the CME quiz: Vol. 29 No. 2, February 2008 Rapid Responses: Submit a response Rapid Responses: View responses Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Friedmann, A. M. Search for Related Content PubMed PubMed Citation Articles by Friedmann, A. M.

(Pediatrics in Review. 2008;29:53-60.)
© 2008 American Academy of Pediatrics

Evaluation and Management of Lymphadenopathy in Children

The first 300 words of the full text of this article appear below.

	Objectives

 
After completing this article, readers should be able to:

1. Define lymphadenopathy.
   
2. Develop a systematic approach to the evaluation and management of lymphadenopathy.
   
3. Discuss the differential diagnosis of localized and generalized lymphadenopathy.
   
4. Recognize worrisome features of lymphadenopathy that should prompt a referral for a biopsy.
   

	Introduction

 
Examining the lymph nodes is an important aspect of the general physical examination of both well and ill children and adolescents. Lymph nodes are normal structures, and certain lymph nodes may be palpable in a healthy patient, particularly in a young child. Conversely, the presence of abnormally enlarged lymph nodes ("lymphadenopathy") can be a clue to a serious underlying systemic disease, and the differential diagnosis of lymphadenopathy can be broad. Thus, the challenge for the general pediatrician is to learn how to distinguish pathologic from nonpathologic lymph nodes and to develop a rational approach to the evaluation of lymphadenopathy. Because of its association with malignancy, lymphadenopathy can be a major source of parental anxiety. Therefore, it is crucial to know when to provide reassurance and to recognize when concern is sufficient to warrant referral to a subspecialist.

	A Review of the Lymphatic System

 
The lymphatic system is an open circulatory system that is a component of the immune system. It includes lymph, lymphatic vessels, lymph nodes, spleen, tonsils, adenoids, Peyer patches, and the thymus. Lymph contains lymphocytes and is an ultrafiltrate of blood that is collected in lymphatic capillaries present throughout the body in all organs except the brain and heart. Lymph moves slowly, without a central pump and under low pressure, via peristalsis and through the milking action of skeletal muscles. Lymph is transported from the head and extremities to progressively larger lymphatic vessels and ultimately into either the right lymphatic duct (lymph from the right upper body) or the thoracic duct (lymph from the rest of the body). These ducts . . . [Full Text of this Article]

Rapid Responses: