Lymphadenopathy: Difference between revisions
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+ | ==Differential Diagnosis== |
− | * |
+ | *Neoplasm |
− | ** |
+ | **Hematologic: [[lymphoma]], [[leukemia]] |
− | ** |
+ | **Solid tumour: [[squamous cell cancer]] of the head and neck |
− | ** |
+ | **[[Metastasis]] |
− | * |
+ | *Infection |
− | ** |
+ | **Viral: [[HIV]], [[EBV]], [[HSV]], [[CMV]], [[mumps]], [[measles]], [[rubella]], [[hepatitis B]], [[dengue]] |
− | ** |
+ | **Bacterial |
− | *** |
+ | ***Regional: [[streptococcal pharyngitis]], [[skin and soft tissue infection]], [[tularemia]], [[plague]], [[cat scratch disease]], [[diphtheria]], [[chancroid]], [[rat bite fever]], [[Lyme disease]] |
− | *** |
+ | ***Generalized: [[brucellosis]], [[leptospirosis]], [[lymphogranuloma venereum]], [[typhoid fever]], [[secondary syphilis]] |
− | ** |
+ | **Mycobacterial: [[tuberculosis]], [[non-tuberculous mycobacteria]] |
− | ** |
+ | **Fungal: [[histoplasmosis]], [[coccidiomycosis]], [[cryptococcosis]] |
− | ** |
+ | **Parasitic: [[toxoplasmosis]], [[leishmaniasis]] |
− | * |
+ | *Non-neoplastic [[lymphoproliferative disorders]] |
− | ** |
+ | **[[Angioimmunoblastic lymphadenopathy with dysproteinemia]] |
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+ | **[[Autoimmune lymphoproliferative disease]] |
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+ | **[[Rosai-Dorfman disease]] |
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+ | **[[Hemophagocytic lymphohistiocytosis]] |
− | * |
+ | *Immune-mediated |
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+ | **[[Serum sickness]] |
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+ | **Drug reactions: [[allopurinol]], [[atenolol]], [[captopril]], [[carbamazepine]], [[cephalosporins]], [[ethosuximide]], [[gold]], [[hydralazine]], [[imatinib]], [[lamotrigine]], [[penicillin]], '''[[phenytoin]]''', [[primidone]], [[pyrimethamine]], [[quinidine]], [[sulfonamides]], [[sulindac]] |
− | ** |
+ | **[[IgG4-related disease]] |
− | * |
+ | *Endocrine and metabolism |
− | ** |
+ | **[[Addison disease]] |
− | ** |
+ | **[[Lipid storage disease]] |
− | * |
+ | *Other |
− | ** |
+ | **[[Sarcoidosis]] |
− | ** |
+ | **[[Multicentric Castleman disease]] |
− | ** |
+ | **[[Amyloidosis]] |
− | ** |
+ | **[[Histiocytosis]] |
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+ | **[[Chronic granulomatous disease]] |
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+ | **[[Kikuchi disease]] |
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+ | **[[Kawasaki disease]] |
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+ | **[[Inflammatory pseudotumor]] |
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+ | **[[Systemic lupus erythematosus]] |
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+ | **[[Rheumatoid arthritis]] |
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+ | **[[Still disease]] |
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+ | **[[Dermatomyositis]] |
− | ** |
+ | **[[Eosinophilic granulomatosis with polyangiitis]] |
− | === |
+ | ===Differential by Location=== |
− | * |
+ | *'''Cervical:''' [[EBV]], [[CMV]], [[toxoplasmosis]], [[tuberculosis]] or [[non-tuberculous mycobacteria]] (if more chronic with less tenderness), [[cat scratch disease]], metastatic head-and-neck cancer |
− | * |
+ | *'''Preauricular:''' [[conjunctivitis]], [[Parinaud oculoglandular syndrome]] ([[cat scratch disease]]) |
− | * |
+ | *'''Postauricular:''' [[parietotemporal scalp infection]], [[rubella]] |
− | * |
+ | *'''Suboccipital:''' posterior scalp infection |
− | * |
+ | *'''Supraclavicular:''' [[malignancy]] (especially intraabdominal malignancy) |
− | * |
+ | *'''Axillary:''' infections of the arm (including [[cat scratch disease]]), [[malignancy]] (including breast and metastasis), foreign body reaction to silicone breast implants |
− | * |
+ | *'''Epitrochlear:''' infections of the forearm or hand, [[lymphoma]], [[sarcoidosis]], [[tularemia]], and [[secondary syphilis]] |
− | * |
+ | *'''Inguinal:''' trauma, lower limb infections, [[Sexually-transmitted infection|STIs]] ([[chancroid]], [[LGV]], [[Herpes simplex virus|herpes]], [[syphilis]]), [[malignancy]] (including skin on legs, cervix, vulva, skin on trunk, rectum/anus, ovary, penis) |
− | * |
+ | *'''Generalized:''' |
− | ** |
+ | **'''More common:''' [[HIV]], [[tuberculosis]], [[mononucleosis]], [[lupus]], medications, [[sarcoidosis]], [[lymphoma]] |
− | ** |
+ | **'''Less common:''' [[Castleman disease]], [[Kikuchi disease]], [[Kawasaki disease]], [[angioimmunoblastic T-cell lymphoma]], [[inflammatory pseudotumour]], [[amyloidosis]], [[Kimura disease]], progressive transformation of germinal centres, [[Fosai-Dorfman disease]], [[IgG4-related disease]] |
− | === |
+ | ===Causes by risk factor=== |
− | * |
+ | *'''Animal exposure''' |
+ | **'''Cat:''' [[cat-scratch disease]], [[toxoplasmosis]] |
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− | * |
+ | *'''Undercooked meat:''' [[toxoplasmosis]] |
+ | *'''Tick bite:''' [[Lyme disease]], [[tularemia]] |
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− | ** '''Undercooked meat:''' toxoplasmosis |
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− | * |
+ | *'''Tuberculosis:''' [[tuberculous adenitis]] |
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− | ** '''Tuberculosis:''' tuberculous adenitis |
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+ | *'''High-risk sexual behaviour:''' [[HIV]], [[syphilis]], [[HSV]], [[CMV]], [[hepatitis B]] |
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− | * |
+ | *'''Intravenous drug use:''' [[HIV]], [[endocarditis]], [[hepatitis B]] |
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− | ** '''Intravenous drug use:''' HIV, endocarditis, hepatitis B |
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+ | **'''Southeastern or central US:''' [[histoplasmosis]] |
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+ | **'''Southeast Asia, India, or northern Australia:''' [[scrub typhus]] |
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− | ** |
+ | **'''Central or west Africa:''' African trypanosomiasis |
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+ | **'''Central or South America:''' American trypanosomiasis |
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− | ** '''Central or west Africa:''' African trypanosomiasis |
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− | ** '''Central or South America:''' American trypanosomiasis |
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[[Category:Infectious diseases]] |
[[Category:Infectious diseases]] |
Revision as of 19:34, 15 November 2020
Differential Diagnosis
- Neoplasm
- Hematologic: lymphoma, leukemia
- Solid tumour: squamous cell cancer of the head and neck
- Metastasis
- Infection
- Viral: HIV, EBV, HSV, CMV, mumps, measles, rubella, hepatitis B, dengue
- Bacterial
- Mycobacterial: tuberculosis, non-tuberculous mycobacteria
- Fungal: histoplasmosis, coccidiomycosis, cryptococcosis
- Parasitic: toxoplasmosis, leishmaniasis
- Non-neoplastic lymphoproliferative disorders
- Immune-mediated
- Endocrine and metabolism
- Other
Differential by Location
- Cervical: EBV, CMV, toxoplasmosis, tuberculosis or non-tuberculous mycobacteria (if more chronic with less tenderness), cat scratch disease, metastatic head-and-neck cancer
- Preauricular: conjunctivitis, Parinaud oculoglandular syndrome (cat scratch disease)
- Postauricular: parietotemporal scalp infection, rubella
- Suboccipital: posterior scalp infection
- Supraclavicular: malignancy (especially intraabdominal malignancy)
- Axillary: infections of the arm (including cat scratch disease), malignancy (including breast and metastasis), foreign body reaction to silicone breast implants
- Epitrochlear: infections of the forearm or hand, lymphoma, sarcoidosis, tularemia, and secondary syphilis
- Inguinal: trauma, lower limb infections, STIs (chancroid, LGV, herpes, syphilis), malignancy (including skin on legs, cervix, vulva, skin on trunk, rectum/anus, ovary, penis)
- Generalized:
- More common: HIV, tuberculosis, mononucleosis, lupus, medications, sarcoidosis, lymphoma
- Less common: Castleman disease, Kikuchi disease, Kawasaki disease, angioimmunoblastic T-cell lymphoma, inflammatory pseudotumour, amyloidosis, Kimura disease, progressive transformation of germinal centres, Fosai-Dorfman disease, IgG4-related disease
Causes by risk factor
- Animal exposure
- Undercooked meat: toxoplasmosis
- Tick bite: Lyme disease, tularemia
- Tuberculosis: tuberculous adenitis
- Transfusion or transplant: CMV, HIV
- High-risk sexual behaviour: HIV, syphilis, HSV, CMV, hepatitis B
- Intravenous drug use: HIV, endocarditis, hepatitis B
- Occupational
- Hunters and trappers: tularemia
- Fishermen and butchers: erysipeloid
- Travel-related
- Arizona, southern California, New Mexico, and western Texas: coccidiomycosis
- Southwestern US: plague
- Southeastern or central US: histoplasmosis
- Southeast Asia, India, or northern Australia: scrub typhus
- Central or west Africa: African trypanosomiasis
- Central or South America: American trypanosomiasis
- East Africa, Mediterranean, China, or South/Central America: leishmaniasis
- Mexico, Peru, Chile, India, Pakistan, Egypt, or Indonesia: typhoid fever