Lymphadenopathy

Lymphadenopathy is a term meaning "disease of the lymph nodes." It is,

however, almost synonymously used with "swollen/enlarged lymph nodes".

When the infection is of the lymph nodes themselves, it is called lymphadenitis,

but when the infection is of the lymph channels, it is called lymphangitis.

Contents

• 1 Associated conditions
• 2 Patterns of Benign (Reactive) Lymphadenopathy
• 3 Bilateral Hilar Lymphadenopathy (BHL)
o 3.1 Causes of BHL

• 4 References

Associated conditions

Enlarged lymph nodes are a common symptom in a number of infectious and

cancerous diseases. It is a recognized symptom of many diseases, which
include:

• reactive: acute infection (e.g. bacterial, or viral), or chronic infections

(tuberculous lymphadenitis, cat-scratch disease).
o The most distinctive symptom of bubonic plague is extreme
swelling of one or more lymph nodes that bulge out of the skin as
'buboes'. The buboes often become necrotic and may even rupture.
o Infectious mononucleosis is an acute viral infection, the hallmark of
which is marked enlargement of the cervical lymph nodes.
o it is also a symptom of cutaneous anthrax, measles and Human
African trypanosomiasis, the latter two giving lymphadenopathy in
lymph nodes in the neck
o toxoplasmosis, a parasitic disease, gives a generalized
lymphadenopathy[1]

• tumoral:
o Primary: Hodgkin lymphoma, non-Hodgkin lymphoma, hairy cell
leukemia, give lymphadenopathy in all or a few lymph nodes [1]
o Secondary: metastasis, Virchow's Node, Neuroblastoma

• autoimmune etiology: sarcoidosis, systemic lupus erythematosus,

rheumatoid arthritis all giving a generalized lymphadenopathy.[1]
 • immunocompromised etiology: AIDS. Generalized lymphadenopathy is an
early sign of infection with human immunodeficiency virus (HIV), the virus
that causes acquired immunodeficiency syndrome (AIDS).
"Lymphadenopathy syndrome" has been used to describe the first
symptomatic stage of HIV progression, preceding AIDS-related complex
and full-blown AIDS.[2]

• bites from certain venomous snake species, most notably the black
mamba, kraits, Australian brown snakes, coral snakes, tiger snakes,
taipans, death adders, and some of the more toxic species of cobra.

Patterns of Benign (Reactive) Lymphadenopathy

There are three distinct patterns of benign lymphadenopathy:

• Follicular hyperplasia. Seen in infections, autoimmune disorders, and

nonspecific reactions.
• Paracortical hyperplasia. Seen in viral infections, skin diseases, and
nonspecific reactions.
• Sinus histiocytosis. Seen in lymph nodes draining limbs, inflammatory
lesions, and malignancies.

Bilateral Hilar Lymphadenopathy (BHL)

Bilateral hilar lymphadenopathy is a radiographic term that describes the

enlargement of mediastinal lymph nodes. It is easily and most commonly
identified by a chest x-ray.

Causes of BHL

The following are causes of BHL:[3]

• Sarcoidosis
• Infection
o TB
o Mycoplasma
• Malignancy
o Lymphoma
o Carcinoma
o Mediastinal Tumours
• Organic Dust Disease
o Silicosis
o Berylliosis
• Extrinsic Allergic Alveolitis
o Such as pigeon fancier's lung
• Less common causes also exist: (needs citation)
 o Churg-Strauss syndrome
o Human Immunodeficiency Virus
o Extrinsic allergic alveolitis
o Pneumoconiosis

References

1. Status and anamnesis, Anders Albinsson. Page 12

2. Chris Jennings (1993). "Understanding and Preventing AIDS: A Book for
Everyone".
3. M. Longmore, I. Wilkinson, T. Turmezei, CK. Cheug (2007). Oxford
Handbook of Clinical Medicine 7th Edition. United States, New York:
Oxford University Press, 179. ISBN 0-19356887-1.