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{{Lymphadenopathy}}
{{Lymphadenopathy}}
{{CMG}}; {{AE}} {{RT}}
{{CMG}}; {{AE}}{{ADS}}, {{RT}}{{DYM}} [[Ogechukwu Hannah Nnabude, MD]]
==Overview==
[[Lymphadenopathy]] may be classified according to distribution into 2 groups localized [[lymphadenopathy]] and generalized lymphadenopathy.


==Classification==
==Classification==
Depending upon the involvement of the lymph nodes, lymphadenopathy is classified as 3 types.
Depending upon the involvement of the [[lymph nodes]], [[lymphadenopathy]] is classified into 2 groups, generalized and localized:<ref name="pmid24753638">{{cite journal |vauthors=Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A |title=Peripheral lymphadenopathy: approach and diagnostic tools |journal=Iran J Med Sci |volume=39 |issue=2 Suppl |pages=158–70 |year=2014 |pmid=24753638 |pmc=3993046 |doi= |url=}}</ref>
* '''Localized lymphadenopathy''' : due to localized spot of [[infection]] e.g. an infected spot on the scalp will cause lymph nodes in the neck on that same side to swell up
:
* [[Generalized lymphadenopathy]] : due to generalized infection all over the body e.g. [[influenza]]
*[[Localized lymphadenopathy]]: localized [[adenopathy]] occurs in contiguous groupings of [[lymph nodes]]. In discrete anatomical regions, [[lymph nodes]] are distributed, and their enlargement represents their location's lymphatic drainage. Tender or non-tender, fixed or mobile, and discreet or "matted" together can be the nodes themselves. 75 percent of all lymphadenopathies are localized, with over 50% seen in the region of the head and neck.
** [[Persistent generalized lymphadenopathy]] (PGL) : persisting for a long time, possibly without an apparent cause
 
* [[Dermatopathic lymphadenopathy]] : lymphadenopathy associated with skin disease.[[Tangier disease]] (ABCA1 deficiency) may also cause this.
*[[Generalized lymphadenopathy]]: generalized lymphadenopathy involves [[lymphadenopathy]] in 2 or more non-contiguous sites. due to generalized infection all over the body e.g. [[influenza]].
*[[Persistent generalized lymphadenopathy]] (PGL): persisting for a long time, possibly without an apparent cause.
*[[Dermatopathic]] [[lymphadenopathy]]: [[lymphadenopathy]] associated with skin disease. [[Tangier disease]] (ABCA1 deficiency) may also cause this.
 
[[Lymphadenopathy]] may be classified as follows:
 
*'''Location''':
**[[Tracheobronchial]] [[lymph nodes]].
**[[Mediastinal]] [[lymphadenopathy]]
**Bilateral [[hilar]] [[lymphadenopathy]]
*'''[[Dermatopathic]] [[lymphadenopathy]]''': [[lymphadenopathy]] associated with skin disease.
*'''[[Malignancy]]''': [[Benign]] [[lymphadenopathy]] is distinguished from malignant types which mainly refer to [[lymphomas]] or lymph node [[metastasis]].
 
*'''Extent''':
** [[Localized lymphadenopathy]]: due to localized spot of [[infection]]
** [[Generalized]] [[lymphadenopathy]]: due to systemic infection of the body. In some cases, it may persist for prolonged periods possibly without an apparent cause
 
*'''Size''', where [[lymphadenopathy]] in adults is often defined as a short axis of one or more [[lymph nodes]] is greater than 10mm.<ref name="pmid20080453">{{cite journal |vauthors=Ganeshalingam S, Koh DM |title=Nodal staging |journal=Cancer Imaging |volume=9 |issue= |pages=104–11 |date=December 2009 |pmid=20080453 |pmc=2821588 |doi=10.1102/1470-7330.2009.0017 |url=}}</ref><ref name="pmid17724531">{{cite journal |vauthors=Schmidt AF, Rodrigues OR, Matheus RS, Kim Jdu U, Jatene FB |title=Mediastinal lymph node distribution, size and number: definitions based on an anatomical study |journal=J Bras Pneumol |volume=33 |issue=2 |pages=134–40 |date=2007 |pmid=17724531 |doi=10.1590/s1806-37132007000200006 |url=}}</ref>
{|class="wikitable"
|+cutoff (value)|Upper limit of [[lymph node]] sizes in adults
|-
| Generally || 10&nbsp;mm<ref name="GaneshalingamKoh2009">{{cite journal|last1=Ganeshalingam|first1=Skandadas|last2=Koh|first2=Dow-Mu|title=Nodal staging|journal=Cancer Imaging|volume=9|issue=1|pages=104–111|year=2009|issn=1470-7330|doi=10.1102/1470-7330.2009.0017|pmid=20080453|pmc=2821588}}</ref><ref name="Schmidt JúniorRodrigues2007">{{cite journal|last1=Schmidt Júnior|first1=Aurelino Fernandes|last2=Rodrigues|first2=Olavo Ribeiro|last3=Matheus|first3=Roberto Storte|last4=Kim|first4=Jorge Du Ub|last5=Jatene|first5=Fábio Biscegli|title=Distribuição, tamanho e número dos linfonodos mediastinais: definições por meio de estudo anatômico|journal=Jornal Brasileiro de Pneumologia|volume=33|issue=2|year=2007|pages=134–140|issn=1806-3713|doi=10.1590/S1806-37132007000200006|pmid=17724531|doi-access=free}}</ref>
|-
| [[Inguinal]] || 10<ref name=Torabi2004>{{cite journal | vauthors = Torabi M, Aquino SL, Harisinghani MG | title = Current concepts in lymph node imaging | journal = Journal of Nuclear Medicine | volume = 45 | issue = 9 | pages = 1509–18 | date = September 2004 | pmid = 15347718 }}</ref> – 20&nbsp;mm<ref>{{cite web|url=http://bestpractice.bmj.com/best-practice/monograph/838/diagnosis/step-by-step.html|title=Assessment of lymphadenopathy|website=[[BMJ Best Practice]]|accessdate=2017-03-04}} Last updated: Last updated: Feb 16, 2017</ref>
|-
| [[Pelvis]] || 10&nbsp;mm for [[ovoid]] [[lymph nodes]], 8&nbsp;mm for rounded<ref name=Torabi2004/>
|-
!colspan=2|Neck
|-
| Generally (non-retropharyngeal) || 10&nbsp;mm<ref name=Torabi2004/><ref name=Saba2016>[https://books.google.com/books?id=q7v1CwAAQBAJ&pg=PA432 Page 432] in: {{cite book|title=Image Principles, Neck, and the Brain|author=Luca Saba|publisher=CRC Press|year=2016|isbn=9781482216202}}</ref>
|-
| [[Jugulodigastric]] [[lymph nodes]] || 11mm<ref name=Torabi2004/> or 15&nbsp;mm<ref name=Saba2016/>
|-
| [[Retropharyngeal]] || 8&nbsp;mm<ref name=Saba2016/>
*Lateral [[retropharyngeal]]: 5&nbsp;mm<ref name=Torabi2004/>
|-
!colspan=2|[[Mediastinum]]
|-
| [[Mediastinum]], generally || 10&nbsp;mm<ref name=Torabi2004/>
|-
| Superior [[mediastinum]] and high [[paratracheal]] || 7mm<ref name="SharmaFidias2004"/>
|-
| Low [[paratracheal]] and [[subcarinal]] || 11&nbsp;mm<ref name="SharmaFidias2004">{{cite journal|last1=Sharma|first1=Amita|last2=Fidias|first2=Panos|last3=Hayman|first3=L. Anne|last4=Loomis|first4=Susanne L.|last5=Taber|first5=Katherine H.|last6=Aquino|first6=Suzanne L.|title=Patterns of Lymphadenopathy in Thoracic Malignancies|journal=RadioGraphics|volume=24|issue=2|year=2004|pages=419–434|issn=0271-5333|doi=10.1148/rg.242035075|pmid=15026591|url=https://semanticscholar.org/paper/145256a2605c552c77534f2a509227902440bf7b}}</ref>
|-
!colspan=2| [[Upper abdominal]]
|-
| [[Retrocrural space]] || 6&nbsp;mm<ref name="DorfmanAlpern1991">{{cite journal|last1=Dorfman|first1=R E|last2=Alpern|first2=M B|last3=Gross|first3=B H|last4=Sandler|first4=M A|title=Upper abdominal lymph nodes: criteria for normal size determined with CT.|journal=Radiology|volume=180|issue=2|year=1991|pages=319–322|issn=0033-8419|doi=10.1148/radiology.180.2.2068292|pmid=2068292}}</ref>
|-
| [[Paracardiac]] || 8&nbsp;mm<ref name="DorfmanAlpern1991"/>
|-
| [[Gastrohepatic ligament]] || 8&nbsp;mm<ref name="DorfmanAlpern1991"/>
|-
| Upper [[paraaortic]] region || 9&nbsp;mm<ref name="DorfmanAlpern1991"/>
|-
| [[Portacaval]] space || 10&nbsp;mm<ref name="DorfmanAlpern1991"/>
|-
| Porta hepatis || 7&nbsp;mm<ref name="DorfmanAlpern1991"/>
|-
| Lower [[paraaortic]] region || 11&nbsp;mm<ref name="DorfmanAlpern1991"/>
|}
 
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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[[Category:Inflammations]]
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[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Oncology]]
[[Category:Physical examination]]
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[[Category:Needs overview]]
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Latest revision as of 05:12, 9 December 2021

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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], Raviteja Guddeti, M.B.B.S. [3]Delband Yekta Moazami, M.D.[4] Ogechukwu Hannah Nnabude, MD

Overview

Lymphadenopathy may be classified according to distribution into 2 groups localized lymphadenopathy and generalized lymphadenopathy.

Classification

Depending upon the involvement of the lymph nodes, lymphadenopathy is classified into 2 groups, generalized and localized:[1]

  • Localized lymphadenopathy: localized adenopathy occurs in contiguous groupings of lymph nodes. In discrete anatomical regions, lymph nodes are distributed, and their enlargement represents their location's lymphatic drainage. Tender or non-tender, fixed or mobile, and discreet or "matted" together can be the nodes themselves. 75 percent of all lymphadenopathies are localized, with over 50% seen in the region of the head and neck.

Lymphadenopathy may be classified as follows:

Upper limit of lymph node sizes in adults
Generally 10 mm[4][5]
Inguinal 10[6] – 20 mm[7]
Pelvis 10 mm for ovoid lymph nodes, 8 mm for rounded[6]
Neck
Generally (non-retropharyngeal) 10 mm[6][8]
Jugulodigastric lymph nodes 11mm[6] or 15 mm[8]
Retropharyngeal 8 mm[8]
Mediastinum
Mediastinum, generally 10 mm[6]
Superior mediastinum and high paratracheal 7mm[9]
Low paratracheal and subcarinal 11 mm[9]
Upper abdominal
Retrocrural space 6 mm[10]
Paracardiac 8 mm[10]
Gastrohepatic ligament 8 mm[10]
Upper paraaortic region 9 mm[10]
Portacaval space 10 mm[10]
Porta hepatis 7 mm[10]
Lower paraaortic region 11 mm[10]

References

  1. ↑ Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A (2014). "Peripheral lymphadenopathy: approach and diagnostic tools". Iran J Med Sci. 39 (2 Suppl): 158–70. PMC 3993046. PMID 24753638.
  2. ↑ Ganeshalingam S, Koh DM (December 2009). "Nodal staging". Cancer Imaging. 9: 104–11. doi:10.1102/1470-7330.2009.0017. PMC 2821588. PMID 20080453.
  3. ↑ Schmidt AF, Rodrigues OR, Matheus RS, Kim Jdu U, Jatene FB (2007). "Mediastinal lymph node distribution, size and number: definitions based on an anatomical study". J Bras Pneumol. 33 (2): 134–40. doi:10.1590/s1806-37132007000200006. PMID 17724531.
  4. ↑ Ganeshalingam, Skandadas; Koh, Dow-Mu (2009). "Nodal staging". Cancer Imaging. 9 (1): 104–111. doi:10.1102/1470-7330.2009.0017. ISSN 1470-7330. PMC 2821588. PMID 20080453.
  5. ↑ Schmidt Júnior, Aurelino Fernandes; Rodrigues, Olavo Ribeiro; Matheus, Roberto Storte; Kim, Jorge Du Ub; Jatene, Fábio Biscegli (2007). "Distribuição, tamanho e número dos linfonodos mediastinais: definições por meio de estudo anatômico". Jornal Brasileiro de Pneumologia. 33 (2): 134–140. doi:10.1590/S1806-37132007000200006. ISSN 1806-3713. PMID 17724531.
  6. ↑ 6.0 6.1 6.2 6.3 6.4 6.5 Torabi M, Aquino SL, Harisinghani MG (September 2004). "Current concepts in lymph node imaging". Journal of Nuclear Medicine. 45 (9): 1509–18. PMID 15347718.
  7. ↑ "Assessment of lymphadenopathy". BMJ Best Practice. Retrieved 2017-03-04. Last updated: Last updated: Feb 16, 2017
  8. ↑ 8.0 8.1 8.2 Page 432 in: Luca Saba (2016). Image Principles, Neck, and the Brain. CRC Press. ISBN 9781482216202.
  9. ↑ 9.0 9.1 Sharma, Amita; Fidias, Panos; Hayman, L. Anne; Loomis, Susanne L.; Taber, Katherine H.; Aquino, Suzanne L. (2004). "Patterns of Lymphadenopathy in Thoracic Malignancies". RadioGraphics. 24 (2): 419–434. doi:10.1148/rg.242035075. ISSN 0271-5333. PMID 15026591.
  10. ↑ 10.0 10.1 10.2 10.3 10.4 10.5 10.6 Dorfman, R E; Alpern, M B; Gross, B H; Sandler, M A (1991). "Upper abdominal lymph nodes: criteria for normal size determined with CT". Radiology. 180 (2): 319–322. doi:10.1148/radiology.180.2.2068292. ISSN 0033-8419. PMID 2068292.

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