Lymphadenopathy
Basics
Description
- Term used to describe ≥1 enlarged lymph nodes >10 mm in diameter (for inguinal nodes, >15 mm; for epitrochlear nodes, >5 mm)
- Any palpable supraclavicular and popliteal lymph node is considered abnormal.
Epidemiology
Incidence
Depends on the underlying process that causes lymph node enlargement
Prevalence
Palpable nodes are present in 5–25% of newborns (cervical, axillary, inguinal) and in >50% of older children (all areas except epitrochlear, supraclavicular, and popliteal).
Pathophysiology
- Lymph nodes are often palpable in normal, healthy children.
- Normal lymph nodes: generally <10 mm
- They are present from birth, peak in size between 8 and 12 years of age, and then regress during adolescence.
- Lymph nodes drain contiguous areas.
- Cervical nodes drain head and neck area (up to 15% of biopsied nodes are malignant).
- Axillary nodes drain arm, thorax, and breast.
- Epitrochlear nodes drain forearm and hand.
- Inguinal nodes drain leg and groin.
- Supraclavicular nodes drain thorax and abdomen.
- Lymphatic flow from adjacent nodes or inoculation site brings microorganisms to lymph nodes.
- Lymph node enlargement may occur via any of the following mechanisms:
- Nodal cells may replicate in response to antigenic stimulation (e.g., Kawasaki disease) or malignant transformation (e.g., lymphoma).
- Lymphocyte proliferation due to immune defect (e.g. primary immunodeficiency disease [PIDD])
- Large number of reactive cells from outside node (e.g., neutrophils or metastatic cells) may enter node.
- Foreign material may be deposited into node by lipid-laden histiocytes (e.g., lipid storage diseases).
- Vascular engorgement and edema may occur secondary to local cytokine release.
- Suppuration secondary to tissue necrosis (e.g., Mycobacterium tuberculosis)
- Many systemic infections (e.g., HIV) cause hepatic or splenic enlargement in addition to generalized lymphadenopathy.
Etiology
Usually determined by performing a thorough history and physical exam
Commonly Associated Conditions
Many systemic infections, malignancy, and lymphoproliferative disorders cause hepatic or splenic enlargement in addition to generalized lymphadenopathy.
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Cabana, Michael D., editor. "Lymphadenopathy." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. Medicine Central, im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14020/all/Lymphadenopathy.
Lymphadenopathy. In: Cabana MDM, ed. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14020/all/Lymphadenopathy. Accessed May 29, 2023.
Lymphadenopathy. (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics (7th ed.). Wolters Kluwer Health. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14020/all/Lymphadenopathy
Lymphadenopathy [Internet]. In: Cabana MDM, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2023 May 29]. Available from: https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14020/all/Lymphadenopathy.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Lymphadenopathy
ID - 14020
ED - Cabana,Michael D,
BT - Select 5-Minute Pediatrics Topics
UR - https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14020/all/Lymphadenopathy
PB - Wolters Kluwer Health
ET - 7
DB - Medicine Central
DP - Unbound Medicine
ER -