Generalized lymphadenopathy

DDx

Infection

  • Viral, eg, infectious mononucleosis (Epstein-Barr virus, cytomegalovirus), hepatitis, herpes simplex virus, varicella, rubella, acute HIV infection or AIDS
  • Bacterial, eg, streptococci, staphylococci, cat-scratch disease, tuberculosis, syphilis, tularemia, chancroid, plague, leprosy
  • Fungal, eg, histoplasmosis, coccidioidomycosis
  • Chlamydial, eg, lymphogranuloma venereum
  • Parasitic, eg, toxoplasmosis, leishmaniasis, trypanosomiasis, filariasis
  • Rickettsial, eg, scrub typhus
Malignancy
  • Hodgkin’s or non-Hodgkin’s lymphoma
  • Leukemia
  • Metastatic cancer
  • Virchow’s (left supraclavicular) node: gastrointestinal (classically gastric) cancer
  • Sister Mary Joseph (umbilical) node: gastrointestinal cancer
  • Right subclavian node: lung cancer
Immunologic disease
  • Rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis, Sjögren’s syndrome
  • Drug hypersensitivity
  • Serum sickness
Other
  • Sarcoidosis
  • Amyloidosis
  • Lipid storage disease, eg, Gaucher, Niemann-Pick
  • Hyperthyroidism
  • Castleman’s disease (giant lymph node hyperplasia)
  • Dermatopathic lymphadenitis
  • Kikuchi’s disease (histiocytic necrotizing lymphadenitis)
  • Kawasaki disease
  • Eosinophilic granuloma (Langerhans cell histiocytosis, histiocytosis X)
  • Familial Mediterranean fever
  • Drug-induced pseudolymphoma (classically phenytoin)

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