Lymphadenopathy resident survival guide

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: , Javaria Anwer M.D.[2]

Overview

Lymphadenopathy (LAD) is used to describe abnormal size, consistency, and the number of lymph nodes. Under normal conditions, lymph nodes may not be palpated. The lymph nodes maybe central or peripheral located deep in the subcutaneous tissue. Common causes of lymphadenopathy include infectious and non-infectious. A thorough physical exam is important to establish a differential diagnosis.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

• Life threatening cause 1
• Life threatening cause 2
• Life threatening cause 3

Common Causes

The American Academy of Family Physicians (AAFP) and many research articles utilize a pneumonic CHICAGO to include all causes of lymphadenopathy based on etiology. The causes may also be remembered based on the location of lymph nodes.

• Cancers:
  • Hematologic: Hodgkin's lymphoma, non-Hodgkins lymphoma, leukemia (acute/ chronic), multiple myeloma, mastocytosis, waldenstrom macroglobulinemia.
  • Metastasis: Breast cancer, gastric cancer, liver cancer, renal cancer, lung cancer, and prostate cancer.
• Hypersensitivity :
  • Serum sickness, immunization reactions, graft-vs-host disease, silicone allergy, and drug allergy (such as sulfonamides, allopurinol, carbamazepine, etc).
• Infections:
  • Fungal, Protozoan, Rickettsial (Typhus), Helminthes.
  • Bacterial: Tiberculosis, syphilis (primary and secondary), chancroid, staphylococcus or streptococcal skin infections.
  • Viral: IM, CMV, HIV,lymphadenitis post vaccination, adenovirus, herpes zoster, and hepatitis (infectious), and melioidosis.
  • Chlamydial (lymphogranuloma venereum), protozoan (toxoplasmosis), mycotic (histoplasmosis, coccidioidomycosis, helminthic (filariasis, and rickettsial (typhus).
• Connective tissue disorders:
  • SLE, rheumatoid arthritis, dermatomyositis, sjogren's syndrome, mixed connective tissue disease.
• Atypical lymphoproliferative disorders :
  • Granulomatosis with polyangiitis, Castleman's disease, Wegener's granulomatosis, angioimmunoblastic T-cell lymphoma, lymphomatoid granulomatosis, and angiocentric immunoproliferative disorder.
• Granulomatous:
  • Cryptococcosis, histoplasmosis, berylliosis, cat scratch disease, silicosis, mycobacterial infection.
• Others:
  • Rosai Dorfman disease, Kikuchi disease, pseudotumor of L.N, transformation of germinal centers, and vascular transformation of sinuses.

Diagnosis

Shown below is an algorithm summarizing the diagnosis of [[disease name]] according the the [...] guidelines.

Treatment

Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.

Do's

• The content in this section is in bullet points.

Don'ts

• The content in this section is in bullet points.

References

Template:WikiDoc Sources