The extent of the history and physical is determined by the clinical presentation of the patient. Additionally, the demographic particulars of the patient, including age, gender, exposure to infectious disease, toxins, medications, and their habits, may provide further cues.Īs evidenced above, the critical step in evaluation for adenopathy is a careful history and focused physical exam. A thorough history of any prodromal illness, fever, chills, night sweats, weight loss, and localizing symptoms can be very revealing. The nodes themselves may be tender or non-tender, fixed or mobile, discreet or 'matted' together. Concomitant symptomatology and the epidemiology of the patient and the illness provide further diagnostic cues. Lymph nodes are distributed in discrete anatomical areas, and their enlargement reflects the lymphatic drainage of their location. Localized adenopathy occurs in contiguous groupings of lymph nodes. Generalized lymphadenopathy entails lymphadenopathy in 2 or more non-contiguous locations.

Lymphadenopathy occurs in 2 patterns: generalized and localized. The pattern, distribution, and quality of the lymphadenopathy can provide much clinical information in the diagnostic process. However, an epitrochlear node of above 0.5 cm is deemed to be pathological in an adult. For example, children younger than ten have more hypertrophic immune systems, and nodes up to 2 cm can be considered normal in some clinical situations. However, the reality is that 'normal' and 'enlarged' criteria vary depending on the location of the node and the age of the patient. It is generally held that a node size is considered enlarged when it is more significant than 1 cm. In this reaction, there is some multiplication of the responding resistant cell line, and thus, the node itself increases in size. In this way, the immune system can recognize and react to foreign proteins and mount an immune response or sequester these proteins as appropriate. It consists of a multi-layered sinus that sequentially exposes B-cell lymphocytes, T-cell lymphocytes, and macrophages to an afferent extracellular fluid.

The lymph node functions as an antigen filter for the reticuloendothelial (RE) system of the body. A clear understanding of lymph node function, location, description, and the etiologies of their enlargement is important in the clinical decisions of which cases need rapid and aggressive workup and which need only be observed. However, it is generally recognized that most lymphadenopathy, both localized and generalized, is of benign, self-limited etiology.

Patients and physicians have varying degrees of associated anxiety with the finding of lymphadenopathy as a small number of cases can be caused by neoplasm or infections of consequence, for example, HIV or tuberculosis (TB). © 2003-2024 by Lymph Notes®, all rights reserved.Lymphadenopathy is a common abnormal finding during the physical exam in general medical practice. Replace the advice of a qualified health care professional. This site complies with the HONcode standard for trustworthy health information: transcutaneous electrical nerve stimulation.Methicillin-resistant Staphylococcus Aureus.Lymphology Association of North America.Click to read 'I love my Caregivers' by Wanda

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