Lymphadenopathy Flashcards
What is the function of the lymphatic system?
Lymphatics drain extracellular fluid from tissues.
The fluid is taken to the lymph nodes.
Thus, any infection will reach the lymph nodes
Causes
Infection (viral, bacterial)
Lymphoma
Metastatic cancer
CTD
Bacterial infection - generalised/regional lymphadenopathy?
Regional
Viral infection - generalised/regional lymphadenopathy?
Generalised
Give a common example of a viral cause of lymphadenopathy?
Glandular fever
When examining lymph nodes, which 5 things do you look for
Tenderness - yes or no Consistency - feeling: hard, soft, rubbery Surface - smooth or irregular Skin inflammation - yes or no Tethering - yes or no
Viral cause of lymphadenopathy: Tenderness Consistency Surface Skin inflammation Tethering
Tenderness - yes Consistency - hard Surface - smooth Skin inflammation - No Tethering - No
Bacterial cause of lymphadenopathy: Tenderness Consistency Surface Skin inflammation Tethering
Tenderness - yes Consistency - hard Surface - smooth Skin inflammation - Yes Tethering - maybe
Lymphoma cause of lymphadenopathy: Tenderness Consistency Surface Skin inflammation Tethering
Tenderness - No Consistency - Rubbery/soft Surface - Smooth Skin inflammation - No Tethering - No
Metastatic cancer cause of lymphadenopathy: Tenderness Consistency Surface Skin inflammation Tethering
Tenderness - no Consistency - hard Surface - irregular Skin inflammation - no Tethering - no
Patient with breast abscess, which lymph node region is most likely to have lymph nodes?
Axillary area
Patient with lower limb cellulitis, which lymph node region is most likely to have lymph nodes?
Inguinal area
If lymphoma or other malignancy is suspected, which investigation should be done?
Lymph node biopsy
- ask a surgeon to do this as FNA or core needle biopsy is often insufficient to make the diagnosis since you need a big sample to assess the architecture of the lesion
Why might lymph nodes be hard?
Due to cell infiltration.
Assessing lymph node pathology - histology
Microscopic appearance
Appreciation of architecture
Whole node sample is preferred to CT guided biopsy as this makes it easier
