Sandbox:Javaria: Difference between revisions
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<ref name="pmid22750769">{{cite journal |vauthors=Garg PK, Jain BK, Dubey IB, Sharma AK |title=Generalized lymphadenopathy: physical examination revisited |journal=Ann Saudi Med |volume=33 |issue=3 |pages=298–300 |date=2013 |pmid=22750769 |pmc=6078537 |doi=10.5144/0256-4947.2012.01.7.1525 |url=}}</ref><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 |date=March 2014 |pmid=24753638 |pmc=3993046 |doi= |url=}}</ref><ref name="pmid12484692">{{cite journal |vauthors=Bazemore AW, Smucker DR |title=Lymphadenopathy and malignancy |journal=Am Fam Physician |volume=66 |issue=11 |pages=2103–10 |date=December 2002 |pmid=12484692 |doi= |url=}}</ref><ref name="pmid10549745">{{cite journal |vauthors=Soldes OS, Younger JG, Hirschl RB |title=Predictors of malignancy in childhood peripheral lymphadenopathy |journal=J. Pediatr. Surg. |volume=34 |issue=10 |pages=1447–52 |date=October 1999 |pmid=10549745 |doi=10.1016/s0022-3468(99)90101-x |url=}}</ref><ref name="pmid10189390">{{cite journal |vauthors=Ghirardelli ML, Jemos V, Gobbi PG |title=Diagnostic approach to lymph node enlargement |journal=Haematologica |volume=84 |issue=3 |pages=242–7 |date=March 1999 |pmid=10189390 |doi= |url=}}</ref> | <ref name="pmid22750769">{{cite journal |vauthors=Garg PK, Jain BK, Dubey IB, Sharma AK |title=Generalized lymphadenopathy: physical examination revisited |journal=Ann Saudi Med |volume=33 |issue=3 |pages=298–300 |date=2013 |pmid=22750769 |pmc=6078537 |doi=10.5144/0256-4947.2012.01.7.1525 |url=}}</ref><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 |date=March 2014 |pmid=24753638 |pmc=3993046 |doi= |url=}}</ref><ref name="pmid12484692">{{cite journal |vauthors=Bazemore AW, Smucker DR |title=Lymphadenopathy and malignancy |journal=Am Fam Physician |volume=66 |issue=11 |pages=2103–10 |date=December 2002 |pmid=12484692 |doi= |url=}}</ref><ref name="pmid10549745">{{cite journal |vauthors=Soldes OS, Younger JG, Hirschl RB |title=Predictors of malignancy in childhood peripheral lymphadenopathy |journal=J. Pediatr. Surg. |volume=34 |issue=10 |pages=1447–52 |date=October 1999 |pmid=10549745 |doi=10.1016/s0022-3468(99)90101-x |url=}}</ref><ref name="pmid10189390">{{cite journal |vauthors=Ghirardelli ML, Jemos V, Gobbi PG |title=Diagnostic approach to lymph node enlargement |journal=Haematologica |volume=84 |issue=3 |pages=242–7 |date=March 1999 |pmid=10189390 |doi= |url=}}</ref><ref name="pmid28348622">{{cite journal |vauthors=Ramadas AA, Jose R, Varma B, Chandy ML |title=Cervical lymphadenopathy: Unwinding the hidden truth |journal=Dent Res J (Isfahan) |volume=14 |issue=1 |pages=73–78 |date=2017 |pmid=28348622 |pmc=5356393 |doi=10.4103/1735-3327.201136 |url=}}</ref> | ||
{{familytree/start |summary=Management of lymphadenopathy}} | {{familytree/start |summary=Management of lymphadenopathy}} | ||
{{familytree | | | | | | | | | | Z01 | | | | | | | |Z01='''History'''<div class="mw-collapsible mw-collapsed"><div style="float: left; text-align: left; width: 20em; padding:1em;"><br><div style="float: left; text-align: left; width: 20em; padding:1em;"> | {{familytree | | | | | | | | | | Z01 | | | | | | | |Z01='''History'''<div class="mw-collapsible mw-collapsed"><div style="float: left; text-align: left; width: 20em; padding:1em;"><br><div style="float: left; text-align: left; width: 20em; padding:1em;"> |
Revision as of 13:25, 22 August 2020
History
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Physical exam Appearance of the patient Cachexia or surgical scar marks demonstrating previous malignancy treatment
❑ HEENT
❑ Extremities exam | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Palpable lymph node ❑ Location: (Localized vs generalized)
❑ Dimensions
❑ Tenderness or pain:
❑ Consistency
❑ Mobility
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Labs ❑ CBC with differential
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Diagnostic of self-limiting or benign disease Pharyngitis, URTI, conjunctivitis, cat-scratch disease, etc | Suggests infection/ serious infection | Unexplained | Suggests malignancy | ||||||||||||||||||||||||||||||||||||||||||||||||||
May require specific tests | Perform specific tests ❑ IM: Heterophile Antibody and monospot test | Risk factors for malignancy Family history, age, exposure, etc | Perform specific tests | ||||||||||||||||||||||||||||||||||||||||||||||||||
Excisional biopsy | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Positive | Negative | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Negative | Positive | ||||||||||||||||||||||||||||||||||||||||||||||||||||
❑ Treat with antibiotics if required and/ or symptomatic treatment ❑ For an untreatable or disease with residual symptoms counsel the patient | Treat | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Low risk | High risk | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Specific tests/ biopsy | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Localized | Generalized | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Review history and clues suggesting malignancy | Review history and clues suggesting malignancy | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Observe 3-4 weeks | Specific tests such as CXR, ultrasound, CT, lab workup, biopsy The US findings that help differentiate benign lAD from malignant include: | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Undiagnostic | Diagnostic | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Progress/persists | Regress | ||||||||||||||||||||||||||||||||||||||||||||||||||||
No follow-up | Biopsy | Treatment | |||||||||||||||||||||||||||||||||||||||||||||||||||
Positive | Negative | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Treatment | Follow-up | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Biopsy | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Negative | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Positive | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Treatment | |||||||||||||||||||||||||||||||||||||||||||||||||||||
- ↑ Garg PK, Jain BK, Dubey IB, Sharma AK (2013). "Generalized lymphadenopathy: physical examination revisited". Ann Saudi Med. 33 (3): 298–300. doi:10.5144/0256-4947.2012.01.7.1525. PMC 6078537. PMID 22750769.
- ↑ Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A (March 2014). "Peripheral lymphadenopathy: approach and diagnostic tools". Iran J Med Sci. 39 (2 Suppl): 158–70. PMC 3993046. PMID 24753638.
- ↑ Bazemore AW, Smucker DR (December 2002). "Lymphadenopathy and malignancy". Am Fam Physician. 66 (11): 2103–10. PMID 12484692.
- ↑ Soldes OS, Younger JG, Hirschl RB (October 1999). "Predictors of malignancy in childhood peripheral lymphadenopathy". J. Pediatr. Surg. 34 (10): 1447–52. doi:10.1016/s0022-3468(99)90101-x. PMID 10549745.
- ↑ Ghirardelli ML, Jemos V, Gobbi PG (March 1999). "Diagnostic approach to lymph node enlargement". Haematologica. 84 (3): 242–7. PMID 10189390.
- ↑ Ramadas AA, Jose R, Varma B, Chandy ML (2017). "Cervical lymphadenopathy: Unwinding the hidden truth". Dent Res J (Isfahan). 14 (1): 73–78. doi:10.4103/1735-3327.201136. PMC 5356393. PMID 28348622.