Lymphadenopathy: Differential Diagnosis And Evaluation
Discuss differential diagnosis of cervical lymphadenopathy.
Answer. Following is the differential diagnosis of cervicofacial lymphadenopathy:
“Red Flags Of Lymphadenopathy”
Infective Causes
- Acute lymphadenitis
- Chronic non-specifi lymphadenitis
- Tuberculous lymphadenitis
- Infectious mononucleosis
- Toxoplasmosis
- Cat scratch fever.
“Infectious Causes Of Lymphadenopathy“
Lymphadenopathy Differential Diagnosis
Neoplastic Causes
- Metastatic lymph node enlargement
- Lymphomas, i.e Hodgkin’s lymphoma, Non-Hodgkin’s lymphoma, Burkitts lymphoma
- Chronic lymphatic leukemia.
“Painful Vs Painless Lymphadenopathy”
Other Causes
- Autoimmune diseases, i.e. systemic lupus erythematosus,rheumatoid arthritis.
- HIV infection, Immunosuppression.
Acute Suppurative Lymphadenitis
- It is a bacterial infection leading to acute inflmmation and suppuration of lymph nodes caused by group A streptococci or staphylococci.
- There is presence of tender, enlarged, fim or soft palpable neck lymph nodes.
Evaluation Of Lymphadenopathy
“Fever And Lymphadenopathy: Are They Related?”
Chronic Non-specific Lymphadenitis
- Infections such as chronic tonsillitis, recurrent dental
- infection can lead to chronic non-specifi lymphadenitis.
- There is presence of fim, non-tender, multiple, bilateral lymph node enlargement in neck.
- Tuberculous lymphadenitis
- It is caused by mycobacterium tuberculosis infection.
- Lymph nodes are mattd, enlarged with cold abscess or sinus formation.
“Role Of Cancer In Lymphadenopathy Development”
Infectious Mononucleosis
- Caused by Epstein-barr virus.
- There is presence of generalized lymphadenopathy.
- Monospot test is positive.
“Lymphadenopathy Vs Lymphadenitis: Symptoms And Treatment”
Approach To Lymphadenopathy
Toxoplasmosis
- Caused by Toxoplasma gondii, protozoa through meat.
- Cervical lymphadenopathy is most common.
- Diagnosed by Sabin Feldman dye test.
Cat Scratch disease
- Caused by Bartonella henselae.
- Lymphadenopathy is present.
- Diagnosed by lymph node biopsy with Warthin-Starry staining.
Differential Diagnosis Of Lymphadenopathy
“Autoimmune Diseases Leading To Lymphadenopathy”
Lymphomas
- In Hodgkin’s lymphoma, there is painless progressive enlargement of lymph nodes.
Lymph nodes are smooth,firm, non-tender. In this cervical lymph nodes, i.e. lower deep cervical group in posterior triangle are commonly enlarged.
In this type, peripheral lymph node involvement is not common. - In non-Hodgkin’s lymphoma any group of lymph node is involved. In this type, peripheral lymph node involvement is common.
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