Lymphadenopathy laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]Delband Yekta Moazami, M.D.[3] Ogechukwu Hannah Nnabude, MD

Overview

CBC with differential is a simple test and basic screening for regional and generalized lymphadenopathy. Bacterial, viral, or fungal pathology may be suggested by the number and differentiation of white blood cells. Furthermore, with many hematological neoplasms causing lymphadenopathy, typical white blood cell (WBC) trends are observed.

Laboratory findings

Laboratory findings consistent with the diagnosis of lymphadenopathy may include:

• Complete Blood Count

• Elevated lactate dehydrogenase (LDH)
• Mild neutropenia
• Leukocytosis
• Elevated markers of inflammation and acute phase reactants (e.g. ESR,C-reactive protein, ferritin)

• CBC with manual differential: CBC with differential is a simple test and basic screening for regional and generalized lymphadenopathy. Bacterial, viral, or fungal pathology may be suggested by the number and differentiation of white blood cells. Furthermore, with many hematological neoplasms causing lymphadenopathy, typical white blood cell (WBC) trends are observed.

• EBV serology: Epstein-Barr viral mono is present causing regionalized lymphadenopathy.
• Sedimentation rate: A measure of inflammation though not diagnostic, can contribute to diagnostic reasoning.

• Cytomegalovirus titers

• HIV serology: This serology can be used to diagnose acute HIV syndrome-related lymphadenopathy or to infer the diagnosis of secondary HIV-elated pathologies causing lymphadenopathy.

• Bartonella henselae serology: used for the diagnosis of cat-scratch lymphadenopathy.

• FTA/RPR: can be used for syphilis diagnose as the cause of lymphadenopathy.

• Herpes simplex serology: can determine if the lymphadenopathy is herpes-related. Herpes simplex can produce symptoms that are similar to mononucleosis.

• Toxoplasmosis serology

• Hepatitis B serology
• ANA: is a screening test for SLE that can help establish it as a cause for generalized lymphadenopathy