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Lymphadenopathy – Causes, Symptoms and Treatment

Lymphadenopathy refers to the abnormal enlargement of lymph nodes. It can be caused by infections, inflammation, or serious conditions such as cancer.

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Things worth knowing about "Lymphadenopathy"

Lymphadenopathy refers to the abnormal enlargement of lymph nodes. It can be caused by infections, inflammation, or serious conditions such as cancer.

What Is Lymphadenopathy?

Lymphadenopathy is the medical term for the abnormal enlargement of one or more lymph nodes. Lymph nodes are small, bean-shaped organs of the immune system distributed throughout the body. They filter harmful substances and play a key role in the body's immune defense. When they become enlarged, the condition is referred to as lymphadenopathy. People often notice this as a palpable or visible swelling, for example in the neck, armpit, or groin.

Causes

Lymphadenopathy can have many different causes, broadly grouped into the following categories:

Infections: The most common cause. Bacterial infections (e.g., streptococcal tonsillitis, tuberculosis), viral infections (e.g., infectious mononucleosis, HIV, COVID-19), and fungal or parasitic infections can all cause lymph node swelling.
Autoimmune diseases: Conditions such as systemic lupus erythematosus or rheumatoid arthritis may lead to generalized lymph node enlargement.
Malignant (cancerous) conditions: Lymphomas (e.g., Hodgkin lymphoma, non-Hodgkin lymphoma), leukemias, and metastases from solid tumors are important causes that require thorough evaluation.
Medications: Certain drugs (e.g., phenytoin, allopurinol) can cause lymphadenopathy as a side effect.
Other causes: Sarcoidosis, storage diseases, and reactive inflammation following vaccinations.

Symptoms

The main symptom is the swelling of lymph nodes. Additional symptoms depend on the underlying condition:

Tenderness or pain in the area of the swollen lymph nodes
Redness and warmth of the overlying skin (in cases of infection or inflammation)
Systemic symptoms such as fever, night sweats, and unexplained weight loss (known as B symptoms in lymphoma)
Fatigue and a general feeling of illness

Clinicians distinguish between localized lymphadenopathy (affecting one body region) and generalized lymphadenopathy (affecting multiple body regions simultaneously). The generalized form is more often associated with systemic diseases.

Diagnosis

The evaluation of lymphadenopathy begins with a thorough medical history and physical examination. Depending on clinical suspicion, further investigations may include:

Blood tests: Inflammatory markers (CRP, ESR), complete blood count with differential, and antibody tests for specific pathogens (e.g., EBV, HIV)
Imaging: Ultrasound of the lymph nodes, computed tomography (CT), or magnetic resonance imaging (MRI) to assess the size, shape, and location of enlarged nodes
Biopsy: If a malignant disease is suspected, tissue is removed from the enlarged lymph node and examined histologically.

Treatment

Treatment of lymphadenopathy is directed at the underlying cause:

Infections: Antibiotics for bacterial infections, antiviral agents for certain viral infections; many cases resolve without specific treatment.
Autoimmune diseases: Immunosuppressive and anti-inflammatory medications.
Malignant conditions: Depending on the diagnosis, chemotherapy, radiation therapy, immunotherapy, or surgical removal may be required.
Drug-induced cases: Discontinuation or adjustment of the causative medication.

In many cases, particularly in young patients following an infection, swollen lymph nodes resolve on their own within a few weeks. Swellings that persist for more than four to six weeks, grow rapidly, or are accompanied by B symptoms should be evaluated by a physician promptly.

References

Swartz MH. Textbook of Physical Diagnosis: History and Examination. 8th edition. Elsevier; 2021.
Ferrer R. Lymphadenopathy: Differential Diagnosis and Evaluation. American Family Physician. 1998;58(6):1313-1320. Available at: https://www.aafp.org/pubs/afp/issues/1998/1001/p1313.html
Habermann TM, Steensma DP. Lymphadenopathy. Mayo Clinic Proceedings. 2000;75(7):723-732. doi:10.4065/75.7.723

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