Lymphadenopathy And Splenomegaly

Question 1

What is the difference between localized/regional adnopathy vs generalized adenopathy?

Answer 1

Localized - involvement of a single anatomic area

Generalized - involvement of three or more non contiguous lymph node areas.

Question 2

Is generalized or regional lymphadenopathy associated with non malignant disorders (EBV, CMV, Toxo AIDS, SLE)

Answer 2

Generalized

Question 3

Enlargement of which nodes is always abnormal?

Answer 3

Supraclavicular and scalene

Question 4

Enlarged intraabdominal or retroperitoneal nodes indicates what?

Answer 4

Malignancy

Question 5

What does the presence of mediastinal lymphadenopathy in adults indicate?

In the young?

Answer 5

Tuberculosis 
Histoplasmosis
Sarcoidosis 
Lymphoma 
Lung cancer 

Infectious mononucleosis and sarcoidosis

Question 6

What do we use fine needle aspiration for?

Answer 6

Thyroid nodules

Question 7

A heavy sensation in the LUQ and early satiety may indicate what?

Answer 7

Massive splenomegaly

Question 8

In what diseases is hyperplasia of the spleen seen? (4)

Answer 8

Hereditary spherocytosis
Thalassemia
Response to infection
Autoimmune

Question 9

In what diseases is congestion of the spleen seen? (3)

Answer 9

Liver cirrhosis
Budd Chiari
CHF

Question 10

When the spleen is massively enlarged, and palpable more than 8 cm below the left costal margin, what are the differential diagnosis? (6)

Answer 10

NHL 
CLL 
HCL 
CML 
Myelofibrosis 
PCV

Question 11

What infection does axillary lymphadenopathy indicate?

Answer 11

Catch scratch disease (bartonella)

Question 12

What malignancies does axillary lymphadenopathy indicate?

Answer 12

Melanoma, breast cancer

Question 13

Hard nodes indicate what?

Answer 13

Cancers that induce fibrosis

Question 14

Firm rubbery nodes are found in what?

Answer 14

Lymphomas and chronic leukemia

Question 15

What does a fixed node indicate?

Answer 15

Invading cancer or inflammation

Question 16

What does tenderness in LNs suggest?

Answer 16

Suggests recent, rapid enlargement

Question 17

What is the difference in cause between tender vs painless lymphadenopathy ?

Answer 17

Tender usually caused by a bacterial infection because of rapid growth

Lymphoma would be painless

Question 18

What infections will cause anterior cervical LAD?

Answer 18

EBV, CMV, toxoplasma

Question 19

Which malignancy will cause anterior cervical LAD?

Answer 19

Lymphoma, CLL, head/neck cancer

Question 20

Which infections cause posterior cervical LAD?

Answer 20

EBV, TB

Question 21

Which malignancies cause posterior cervical LAD?

Answer 21

Lymphoma, CLL, head and neck cancer

Question 22

What causes supraclavicular LAD? (Right vs left)

Answer 22

Malignancy

Right side: cancer in the mediastinum, lung, esophagus
Left side: virchows node

Question 23

Which infections cause axillary LAD?

Answer 23

Bartonella henselae

Question 24

Which malignancy cause axillary LAD?

Answer 24

Breast cancer, skin cancer

Question 25

What causes epitrochlear LAD?

Answer 25

Forearm/hand infections 
Tularemia 
Streptococcal
Catch scratch disease 
Sarcoidosis 
Lymphoma

Question 26

What causes inguinal LAD?

Answer 26

Lower extremity infection 
STD 
Lymphoma 
Melanoma 
Non melanoma skin cancer