Lymphadenopathy Flashcards
Define lymphadenopathy?
Enlargement of one of more lymph nodes
What are the 3 general causes of lymphadenopathy?
Infection
Neoplasm
Autoimmune disease
What 4 types of infection can cause lymphadenopathy?
Bacterial
Fungal
Viral
Protozoal
Give 5 types of bacterial infections that commonly cause lymphadenopathy?
Streptococcal
TB
Brucellosis
Typhoid fever
Cat scratch fever
Give 2 types of viral infections that commonly cause lymphadenopathy?
HIV
EBV
Give a type of fungal infection that commonly causes lymphadenopathy?
Histoplasmosis
Give 2 types of protozoal infections that commonly cause lymphadenopathy?
Toxoplasmosis
Malaria
How can someone acquire toxoplasmosis, and how can you identify this in a patient history?
Acquired from dogs
Ask patient if they have pets or have come into contact with any animals
How can someone acquire cat scratch fever, and how can you identify this in a patient history?
Acquired from cats
Ask patient if they have pets or have come into contact with any animals
If lymphadenopathy is caused by a primary tumour, what is the most likely origin of the tumour and why?
Haematological cancer, as the origin cell types directly involve lymphoreticular system
If lymphadenopathy is caused by a primary tumour, is the tumour more likely to be a haematological cancer or solid organ cancer?
Haematological cancer, as the origin cell types directly involve lymphoreticular system
Solid organ cancer doesn’t directly involve lymphoreticular system
Which 5 types of cancer are most likely to cause lymphadenopathy due to metastasis?
Lung
Breast
Thyroid
Melanoma
Stomach
Give 4 examples of autoimmune diseases that commonly cause lymphadenopathy?
SLE
Sarcoidosis
RA
Connective tissue diseases
What are the 2 presentations of lymphadenopathy, regarding the distribution of affected lymph nodes?
Generalised
Localised
Define generalised lymphadenopathy?
Lymphadenopathy in 2 or more noncontiguous lymph node groups
Define localised lymphadenopathy?
Lymphadenopathy in one lymph node group only
What is often the general cause of generalised lymphadenopathy?
Underlying haematological malignancy (neoplasm)
Not common when secondary to infection or autoimmune disease
What are the 2 common causes of localised lymphadenopathy?
Infection in the same region
Solid tumour which is draining into regional lymph node group
When lymphadenopathy presents, what is usually the speed of onset?
Swells rapidly
When a swollen lymph node is painful to touch, what are the 2 most likely underlying causes?
Infection or autoimmune disease flare up
Reactive lymphadenopathy
When a swollen lymph node is painless to touch, what is the most likely underlying cause?
Malignancy (neoplasm)
In lymphadenopathy, what fluid do enlarged lymph nodes usually drain?
Pus
Give 5 associated symptoms of lymphadenopathy, and which of these 3 are red flag symptoms?
Weight loss (RED FLAG)
Fatigue
Shortness of breath
Night sweats that require changing clothes (RED FLAG)
Long-term fever (RED FLAG)
What are the 3 common red flag symptoms of lymphadenopathy, and what is the most likely underlying cause?
Weight loss, drenching night sweats, long-term fever
Haematological malignancy
What physical examination is done to assess lymphadenopathy?
Lymphoreticular exam
What is the gold standard group of lab tests for diagnosis of lymphadenopathy origins?
Tissue diagnosis
Give 5 underlying causes of lymphadenopathy that can be accurately diagnosed using FNA cytology?
Reactive hyperplasia
Infections
Granulomatous lymphadenopathies
Lymphomas
Metastatic malignancies
How can FNA cytology be improved to accurately diagnose when metastasis has caused lymphadenopathy?
Ultrasound-guided to examine suspicious areas of lymph node such as where metastasis could have occurred
How can FNA cytology be improved to accurately diagnose when lymphoma has caused lymphadenopathy?
Immunochemistry and flow cytometry
Why is FNA cytology not the gold standard lab test for diagnosing Hodgkin’s lymphoma as the cause of lymphadenopathy?
Has high rate of false-negative results for Hodgkin’s lymphoma
Why is FNA cytology not the gold standard lab test for diagnosing Non-Hodgkin’s lymphoma as the cause of lymphadenopathy?
Provides vague classification of non-Hodgkin’s lymphoma
What lab test is completed to investigate if lymphadenopathy has originated from a skin lesion?
Skin biopsy
What blood tests are done to diagnose infections and autoimmune diseases as the underlying cause of lymphadenopathy?
FBC
Differential, complete metabolic panel
Fungal serologies
QuantiFERON: TB
What mode of radiological investigation is ideally used for peripheral lymphadenopathy?
Ultrasonography
What is the main reason for using Colour-doppler sonography to investigate lymphadenopathies?
Can distinguish between old and active lymphadenopathies
CT and MRI are used to investigate lymphadenopathies in which 2 body regions?
Thoracic cavity
Abdominopelvic cavity
Give 2 examples of primary tumours that commonly cause lymphadenopathies?
Lymphoma
Leukaemia
Give 2 examples of drugs that cause lymphadenopathy and 1 example that doesn’t?
Phenytoin, hydralazine
Amiodarone
