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- Shashi Sahai, MD*
- *The Carman and Ann Adams Department of Pediatrics, Division of Hospital Medicine, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI.
Author Disclosure
Dr Sahai has disclosed she owns stocks/bonds in Dr. Reddy's Laboratories, Ltd., and Roche Holding, A.G. This commentary does not contain discussion of unapproved/investigative use of a commercial product/device.
Practice Gaps
Diffuse lymphadenopathy should always be evaluated by careful history and physical examination and perhaps laboratory investigation.
The absence of any palpable lymph nodes in the presence of symptoms suggesting infection in that drainage area should raise suspicion for immunodeficiency diseases.
Supraclavicular adenopathy is always abnormal and the chances of malignancy are high.
Objectives
After completing this article, readers should be able to:
Define lymphadenopathy
Know the differential diagnosis for localized and generalized lymphadenopathy
Know the etiology and evaluation of acute and chronic cervical lymphadenopathy
Know the age-dependent microbiology of acute cervical lymphadenitis
Recognize the “red flags” associated with noninfectious causes of lymphadenopathy
Introduction
Lymphadenopathy is defined as an abnormality in size and consistency of lymph nodes, while the term lymphadenitis refers to lymphadenopathy that occurs from infectious and other inflammatory processes. Lymph node enlargement is a common finding on physical examinations of children. In fact, the absence of any palpable lymph node in the presence of symptoms that suggest infection in a drainage area should raise suspicion for an immunodeficiency disease. The presence of an enlarged lymph node may be a source of anxiety in parents because of its association with malignancy. Although infections are the most common cause of lymph node enlargement, clinicians must be aware of a broad range of other disease processes that lead to lymph node enlargement.
Anatomy and Physiology
The lymphatic system is comprised of lymphatic vessels and lymphoid organs. The lymphatic vessels transport interstitial fluid back to the circulating blood. Lymph is an ultrafiltrate of blood. It is collected through the lymphatic capillaries that are present throughout the body. The brain and heart are the only organs that …
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