Cervical lymphadenopathy
Cervical lymphadenopathy refers to lymphadenopathy of the cervical lymph nodes (the glands in the neck). The term lymphadenopathy strictly speaking refers to disease of the lymph nodes,[1] though it is often used to describe the enlargement of the lymph nodes. Similarly, the term lymphadenitis refers to inflammation of a lymph node, but often it is used as a synonym of lymphadenopathy.
Cervical lymphadenopathy is a sign or a symptom, not a diagnosis. The causes are varied, and may be inflammatory, degenerative, or neoplastic.
Classification
Cervical lymphadenopathy can be thought of as local where only the cervical lymph nodes are affected, or general where all the lymph nodes of the body are affected.
Causes
Infection
- Pericoronitis[5]
- Staphylococcal lymphadenitis[1]
- Mycobacterial lymphadenitis[1]
- Rubella
- Cat scratch fever[1]
- Infectious mononucleosis[6]
- Streptococcal pharyngitis
- Viral respiratory infection
- Toxoplasmosis[7]
- Tuberculosis[7]
- Brucellosis[8]
- Primary herpes simplex infection (primary herpetic gingivostomatitis)[1]
- Syphilis (secondary)[1]
- Cytomegalovirus[1]
- Human immunodeficiency virus[1]
- Histoplasmosis[5]
- Chicken pox[5]
Malignancy
Lymph nodes may become enlarged in malignant disease. This cervical lymphadenopathy may be reactive or metastatic.[1] Alternatively, enlarged lymph nodes may represent a primary malignancy of the lymphatic system itself, such as lymphoma (both Hodgkin's and non-Hodgkin's),[6] lymphocytic leukemia,[1] Lymphadenopathy that lasts less than two weeks or more than one year with no progressive size increase has a very low likelihood of being neoplastic.[9]
Metastatic lymph nodes are enlarged because tumor cells have detached from the primary tumor and started growing in the lymph node ("seeded"). Since cancer generally occurs more frequently in older people, this kind of lymphadenopathy is more common in older persons.[7] Metastatic lymph nodes tend to feel hard and may be fixed to underlying tissues and may or may not be tender.[7] Usually the lymph nodes that directly drain the area of the cancer are affected by the spread (e.g. Sometimes metastatic cervical lymph node is detected before the main cancer). In such cases, this discovery leads to a search for the primary malignancy, firstly in the nearby area with endoscopy, "blind" biopsies, and tonsillectomy on the side of the lymphadenopathy. If no tumor is found, then the rest of the body is examined, looking for lung cancer or other possible sites. If still no primary tumor is detected, the term "occult primary" is used.[8]
In lymphoma, usually there are multiple enlarged nodes which feel rubbery to palpation.[8]
Other causes
- Surgical trauma, e.g. following a biopsy in the mouth[4]
- Kawasaki disease,[5]
- Kikuchi-Fujimoto disease
- Rosai-Dorfman disease
- Castleman disease
- Sarcoidosis[1]
- Lupus erythematosus[7]
- Cyclic neutropenia[5]
- Orofacial granulomatosis[10]
Diagnosis
In possible malignancy, it is routine to perform a
On
References
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- ISBN 978-0-8138-2131-3.
- PMID 9803196.
- ^ ISBN 9780323049030.
- ^ ISBN 9780443068188.
- ^ ISBN 978-1-60327-519-4.
- ^ ISBN 9780198566236.
- ^ ISBN 9780443067846.
- ISSN 0331-3131.
- S2CID 33359041.
- ^ PMID 22312490.
- ^ PMID 18390388.