Headlines:

Back to Lymph Node Enlargement

Lymph Node Enlargement

Causes of generalized lymphadenopathy

Editors Note:
Generalized lymphadenopathy is always a puzzling entity. The presence of fever may suggest an infectious cause or lymphoma. The presence of rash may suggest an infectious or autoimmune process. Request a full blood count to exclude hematological causes. A lymph node biopsy is needed if the picture is suggestive of lymphoma.

Essentially 5 broad etiologic categories lead to lymph node enlargement (Ghirardelli, 1999).

• An immune response to infective agents (eg, bacteria, virus, fungus)
• Inflammatory cells in infections involving the lymph node
• Infiltration of neoplastic cells carried to the node by lymphatic or blood circulation (metastasis)
• Localized neoplastic proliferation of lymphocytes or macrophages (eg, leukemia, lymphoma)

• Infiltration of macrophages filled with metabolite deposits (eg, storage disorders)

Infections

• Infectious mononucleosis.
• Cytomegalovirus may cause a syndrome similar to infectious mononucleosis.
• TB: In a child with tuberculosis, generalized lymphadenopathy may indicate hematogenous spread of tubercle bacilli.
• Brucellosis may accompany chronic or intermittent lymphadenopathy.
• Salmonella infection can correspond to generalized adenopathy.
• Tularemia may be accompanied by regional or generalized adenopathy, most commonly cervical, with local tenderness, pain, and fever.
• Bubonic plague is caused by Y pestis.

Immunologic or connective tissue disorders

• Juvenile rheumatoid arthritis should be considered in unexplained fever and persistent lymphadenopathy in a child.
• Serum sickness can correspond with generalized tender lymphadenopathy.
• Chronic graft versus host disease.

Primary disease of lymphoid or reticuloendothelial tissue

• Acute leukemia
• Hodgkin disease
• Non-Hodgkin lymphoma
• Lymphosarcoma
• Nonendemic Burkitt tumor
• Nasopharyngeal rhabdomyosarcoma
• Neuroblastoma
• Reticulum cell sarcoma
• Malignant histocytosis or histocytic lymphoma
• Thyroid carcinoma, chronic lymphocytic thyroiditis
• Histiocytosis X
• Benign sinus histiocytosis
• Angioimmunoblastic or immunoblastic lymphadenopathy
• Chronic pseudolymphomatous lymphadenopathy (chronic benign lymphadenopathy)

Immunodeficiency syndromes

• Acquired immunodeficiency syndrome
• Chronic granulomatous disease of childhood
• Hyperimmunoglobulin E (Job) syndrome

		Are you a doctor or a nurse? Do you want to join the Doctors Lounge online medical community? Participate in editorial activities (publish, peer review, edit) and give a helping hand to the largest online community of patients. Click on the link below to see the requirements: Doctors Lounge Membership Application

Metabolic and storage diseases

• Gaucher disease
• Histiocytosis X
• Cystinosis
• Niemann-Pick disease

Hematopoietic diseases

• Thalassemia
• Congenital hemolytic anemia
• Autoimmune hemolytic anemia
• Sickle cell anemia

Other disorders

• Sarcoidosis demonstrate either generalized or hilar lymphadenopathy.
• Drug: mesantoin, hydantoin use may produce lymphadenopathy as an adverse effect.
• Castleman disease or benign giant lymph node hyperplasia may cause lymphadenopathy in the mediastinum, abdomen, neck, or axilla.
• Kawasaki disease

References

1. Ghirardelli ML, Jemos V, Gobbi PG: Diagnostic approach to lymph node enlargement. Haematologica 1999 Mar; 84(3): 242-7.

send to a friend printer friendly version
The Oncology Discussion Board     Breast Cancer Topics       Colon and Rectal Cancers Topics       Lung Cancer Topics The Oncology Articles