Cervical Lymphadenopathy

Question 1

What is it?

Answer 1

Enlargement of lymph nodes in the neck

Question 2

What causes it?

Answer 2

Generally by benign conditions such as Upper Respiratory Tract Infection but can also be inflammatory, degenerative or neoplastic

Question 3

Which nodes are suspicious?

Answer 3

Supra and infraclavicular nodes, nodes that are firm, non-tender and matted together

Question 4

Investigations (10)

Answer 4

Thorough history and clinical examination, unexplained requires: FBC, Blood Film, ESR, Plasma Viscosity, CRP and LFTs, Infection swabs from primary infection site, viral titres, Autoantibody screen e.g SLE, CXR (to rule out secondary malignancy), CT, MRI, fine needle aspiration, excisional biopsy

Question 5

Differentials (5)

Answer 5

Subcutaneous lesions e.g lipoma, abscess; Hernia, Sebaceous cyst, Thyroid tumour, Thyroglossal Cyst

Question 6

Treatment (5)

Answer 6

Recognition and exclusion of serious disease, seek advice following URTI if lymphadenopathy doesn’t resolve, antimicrobials if suspected infection, excision, may require chemo/radiotherapy

Question 7

Complications (1)

Answer 7

Superior Vena Cava Obstruction

Question 8

Is there a good prognosis?

Answer 8

Depends on the cause