Etiology of lymphadenopathy

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Etiology of lymphadenopathy

  1. 1. LYMPHADENOPATHY-ETIOLOGY
  2. 2. Lymphadenopathy - pathophysiology Lymph node enlargement may occur via any of the following mechanisms:  Nodal cells may replicate in response to antigenic stimulation or malignant transformation (e.g., lymphoma).  Large number of reactive cells from outside node (e.g., neutrophils or metastatic cells) may enter node.  Foreign material may be deposited into node by lipid-laden histiocytes (e.g., lipid storage diseases).  Vascular engorgement and edema may occur secondary to local cytokine release.  Suppuration secondary to tissue necrosis (e.g., Mycobacterium tuberculosis)
  3. 3. Clinically 2 types Generalised and Localised
  4. 4. Generalized adenopathy has beendefined as  involvement of three or more noncontiguous lymph node areas.  generalized lymphadenopathy is frequently associated with nonmalignant disorders
  5. 5. 1.Common infectious causes:Bacterial Group A streptococcus Mycobacteria: typical and atypical Anaerobic bacteria Diphtheria Brucellosis Actinomycetes Gram –ve enterios
  6. 6. Common infectious causes:Viral  Epstein-Barr virus  Herpes simplex  Measles  Mumps  Coxsackie  Adenovirus  HIV  Rubella
  7. 7. Common infectious causes:Fungal / *Parasitic  Aspergillosis  Candida  Cryptococcus  Histoplasmosis  Coccidioidomycosis  Sporotrichosis  Blastomycosis  Toxoplasmosis*
  8. 8. 2.Immunologic diseases.a. Rheumatoid arthritisb. Juvenile rheumatoid arthritisc. Mixed connective tissue diseased. Systemic lupus erythematosuse. Dermatomyositisf. Sjögren’s syndromeg. Serum sickness
  9. 9. h. Drug hypersensitivityi. Primary biliary cirrhosisj. Graft-versus-host diseasek. Silicone-associated
  10. 10. a. Hematologic—Hodgkin’s disease, non- Hodgkin’s lymphomas, acute or chronic lymphocytic leukemia, hairy cell leukemia, malignant histiocytosis, b. Metastatic—from numerous primary sites
  11. 11. 4. Lipid storage diseases—Gaucher’s, Niemann-Pick5. Endocrine diseases—hyperthyroidism
  12. 12. 6. Other disordersa. Castleman’s disease (giant lymph nodehyperplasia)b. Sarcoidosisc. Dermatopathic lymphadenitisd.Histiocytic necrotizing lymphadenitise. Sinus histiocytosis with massive lymphadenopathyf. Mucocutaneous lymph node syndrome (Kawasaki’sdisease
  13. 13. g. Familial Mediterranean feverh. Severe hypertriglyceridemiai. Vascular transformation ofsinuses j. Inflammatory pseudotumor oflymph node
  14. 14. Few causes of large nodes Lymphangitis  Acute  Suppurative-staphylococci most common cause-mode is firm and tender, erythematous and swollen  Cat Scratch- most common cause, node lasting longer than 3 wks. Found in any nodes, large, red, tender Hodgkin- malignant nodes matted, firm, rubbery, asymmetry is the rule Non-Hodgkin-malignant-well defined and solid, nontender Lymphadenitis – node it’s self is infected- one node enlarged, red , warm, tender- no streaking
  15. 15. Mimicking Lymphadenopathy: Branchial cleft cyst Cystic hygroma Thyroglossal duct cyst Epidermoid cyst Sternocleidomastoid tumor
  16. 16. Mimicking Lymphadenopathy: Branchial cleft cyst Cystic hygroma Thyroglossal duct cyst Epidermoid cyst Sternocleidomastoid tumor
  17. 17.  The causes of lymphadenopathy is broad. A patients medical history and review of systems is important in narrowing this differential. Upon examination, recognizing the pattern of lymph drainage aids in seeking an infectious focus.
  18. 18. THANK YOU!!!!

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