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Lymphadenopathy

Lymphadenopathy is an enlargement of lymph nodes. Our body contains approximately 600 lymph nodes which have numerous functions. Only some groups of lymph nodes including submandibular and submental, cervical lymph nodes, axillary and inguinal lymph nodes are available for palpation and even the patient can notice their enlargement. Internal lymph nodes can also get bigger and their enlargement usually compresses surrounding organs and tissues leading to specific symptoms. In case of internal lymph nodes the symptoms vary according to the very localization of the enlarged lymph nodes.

Lymphadenopathy can be painful and painless. If there is enlargement of lymph nodes in only two or more noncontiguous areas lymphadenopathy is classified as generalized while localized lymphadenopathy refers to enlargement of only one group of lymph nodes.

Lymphadenopathy is basically painless. Only if the affected lymph nodes become too big they can compress surrounding structures including nerves and cause pain. Painful enlargement of lymph nodes is also evident if lymph nodes are affected by certain infections.Causes of Lymphadenopathy

Lymph nodes get bigger in a variety of infectious diseases as well in malignancies.

Reactive lymphadenopathy is enlargement of lymph nodes induced by bacterial or viral infections. Lymph nodes can additionally enlarge due to certain chronic diseases such as tuberculosis and cat-scratch disease. Bubonic plague typically features with huge lymph nodes. They are so specific and are called buboes. The necrotic process inside the affected lymph nodes eventually leads to their rupture. Enlarged cervical lymph nodes, especially if accompanied by enlargement of the liver and/or spleen, points to mononucleosis. Furthermore, antrax and trypanosomiasis also feature with enlarged lymph nodes of the neck. Generalized lymphadenopathy is detected in toxoplasmosis.

Many tumors, primary or metastatic, may cause painful or painless lymphadenopathy. Primary tumors which affect lymph nodes include Hodgkin and non-Hodgkin lymphoma as well as hairy cell leukemia. Lymphadenopathy also occurs in secondary spread of the tumors of nearby, or distant organs. Lymphadenopathy can additionally be caused by certain autoimmune diseases such as systemic lupus erithematosus, rheumatoid arthritis or sarcoidosis.

And finally, patients who are immunocompromized as well as those suffering from HIV or AIDS also develop lymphadenopathy at some point.

Painful enlargement of lymph nodes is typical after venomous snake bites.

Diagnostic Approach to Lymphadenopathy

In majority of patients painful or painless lymphadenopathy is caused by infections. The affected lymph nodes reduce in size thanks to appropriate treatment and after certain period of time. However, if lymph nodes tend to stay enlarged or even grow bigger even though patients are under treatment the doctor needs to perform biopsy of the affected lymph nodes to find the underlying cause. Prolonged enlargement is either connected to chronic infections or to malignancies.

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