INFO - On lymphadenopathy (chronic, abnormal enlargement of lymph nodes)

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American Family Physician

Lymphadenopathy: Differential Diagnosis and Evaluation

ROBERT FERRER, M.D., M.P.H.,

University of Texas Health Sciences Center at San ,

San , Texas

Although the finding of lymphadenopathy sometimes raises fears about serious

illness, it is, in patients seen in primary care settings, usually a result

of benign infectious causes. Most patients can be diagnosed on the basis of

a careful history and physical examination. Localized adenopathy should

prompt a search for an adjacent precipitating lesion and an examination of

other nodal areas to rule out generalized lymphadenopathy. In general, lymph

nodes greater than 1 cm in diameter are considered to be abnormal.

Supraclavicular nodes are the most worrisome for malignancy. A three- to

four-week period of observation is prudent in patients with localized nodes

and a benign clinical picture. Generalized adenopathy should always prompt

further clinical investigation. When a node biopsy is indicated, excisional

biopsy of the most abnormal node will best enable the pathologist to

determine a diagnosis.

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http://www.aafp.org/afp/981015ap/ferrer.html

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