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Peripheral lymphadenopathy in children: Evaluation and diagnostic approach

Author
Kenneth L McClain, MD, PhD
Section Editors
Sheldon L Kaplan, MD
Donald H Mahoney, Jr, MD
Jan E Drutz, MD
Deputy Editor
Mary M Torchia, MD

INTRODUCTION

Lymphadenopathy is common and usually not clinically important in and of itself. However, it can be a manifestation of serious underlying disease. The challenge for clinicians is to avoid aggressive evaluation and biopsy of most children, while making timely, specific diagnoses in children with serious underlying disease.

This topic will provide guidelines for our approach to the evaluation of peripheral lymphadenopathy in children. The guidelines are intended to supplement clinical judgment in the absence of research that directly addresses how children with unexplained lymphadenopathy should be evaluated. The causes of peripheral lymphadenopathy in children (table 1A-B and table 2), cervical lymphadenitis in children, and peripheral lymphadenitis in adults are discussed separately. (See "Peripheral lymphadenopathy in children: Etiology" and "Cervical lymphadenitis in children: Etiology and clinical manifestations" and "Evaluation of peripheral lymphadenopathy in adults".)

ANATOMY AND DEFINITIONS

The location of peripheral lymph node groups is shown schematically in the figures (figure 1 and figure 2).

"Lymphadenopathy" refers to enlargement of the lymph nodes. The threshold for enlargement varies with location. (See 'Lymph nodes' below.)

Strictly speaking, "lymphadenitis" refers to enlarged lymph nodes that are inflamed, but it is often used interchangeably with "lymphadenopathy."

                               

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Literature review current through: Aug 2016. | This topic last updated: Apr 28, 2016.
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