Infectious exposure and immunization status should be reconciled. Copyright © 2016 American Academy of Family Physicians.Įnvironmental, travel, insect, and animal exposure should always be accounted for during evaluation.
Unexplained Lymphadenopathy: Evaluation and Differential Diagnosis. Some important things to always ask about are how long the lymphadenopathy has been present, exposures, where the lymphadenopathy is located, and associated symptoms such as fever, night sweats, sore throat, nausea, vomiting, abdominal pain, unintended weight loss, high-risk sexual behaviors, exposure to any new animals, recent travel, joint pain, rash, or muscles soreness. Often, the history and examination will aid in the identification of the reason for lymph node enlargement. Just like every patient, start off with an appropriate history and physical examination. Copyright © 2016 American Academy of Family Physicians. Malignancy, infection, autoimmune disease, miscellaneous causes, and iatrogenic causes. 1Ĭauses of lymphadenopathy can be remembered by the mnemonic, MIAMI. In around 4 percent of patients 40 years and older, cancer is found to be the underlying cause, whereas if under 40 years of age, around 0.4% of cases are found to be due to malignant etiologies. 1 Age is a risk factor for unexplained lymphadenopathy being related to cancer. However, only around 1.1 percent of these instances are caused by malignancy. In around 0.6 percent of cases of lymphadenopathy, the etiology remains unknown. However, there are some additional circumstances where small lymph nodes should attract some concern, such as if lymphadenopathy is seen in the supraclavicular, popliteal, iliac, and epitrochlear regions that are greater than 5 mm in size. Lymphadenopathy is considered to be abnormal if the size is greater than 1 centimeter or if there is an abnormal consistency (such as being matted, fixed, or hard). Today we will discuss etiologies, an approach to diagnosis, and potential treatment based on specific etiologies of lymphadenopathy. Numerous etiologies can present with lymphadenopathy, and the workup can be extensive. Enlarged lymph nodes can be a robust chief complaint to tackle.
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