neck lumps Flashcards
1
Q
causes of lymphadenopathy:
- reactive + infective? 3
- reactive + non-infective? 6
- infiltrative?
A
REACTIVE + INFECTIVE
- bacterial (e.g. pyogenic, TB, brucella, syphillis)
- viral (EBV, HIV, CMV, infectious hepatitis)
- others (toxoplasmosis, trypanosomiasis)
REACTIVE + NON-INFECTIVE
- sarcoidosis
- amyloidosis
- berylliosis
- connective tissue disease (e.g. SLE, rheumatoid)
- dermatological (eczema, psoriasis)
- drugs (e.g. phenytoin)
INFILTRATIVE
- benign histiocytosis
- haem cancers (lymphoma or leukaemia - ALL, CLL, AML)
- metastatic cancers (breast, lung, bowel, prostate, kidney, head/neck)
2
Q
describe which lymph nodes you feel for in a neck exam (and where they are)
9
A
- supraclavicular (incl on the left: virchov’s, normally gastric Ca)
- anterior cervical (anterior to SCM)
- posterior cervical (posterior to SCM)
- tonsilar (under corner of mandible)
- submandibular
- submental (under chin)
- preauricular
- post auricular (around mastoid)
- occipital
https: //doctorslounge.com/oncology/diagnosis/lymph_node/cervical.htm
3
Q
difference in presentation between inflammatory/infective causes of lymphadenopathy + malignant causes?
incl associated symptoms
A
inflam
- acute
- painful/tender
- red
- swollen
- specific to drainage of particular area (e.g. external ear infection -> pre-auricular nodes)
- other signs of infection (tonsillitis, glandular fever etc)
lymphoma or leukaemia
- painless
- generalised lymphadenopathy (esp post triangle, axillae + inguinal)
- nodes are enlarged + rubbery
- systemic B symptoms (pallor, fatigue, weight loss, night sweats, fever, hepatomegaly)
metastatic cancer
- enlarged painless nodes at drainage site of where organ is (e.g. breast -> axillae)
- symptoms/signs of underlying cancer
4
Q
differential diagnoses for cervical lymphadenopathy? 8
A
- skin infections
- benign tumours
- malignant primary tumours
- thyroid lumps
- salivary gland lumps
- congenital + developmental lumps/cysts etc
- carotid body tumours/aneurysms
- trauma
