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Evaluation of peripheral lymphadenopathy in adults

Robert L Ferrer, MD, MPH
Section Editors
Mark D Aronson, MD
Arnold S Freedman, MD
Deputy Editor
Daniel J Sullivan, MD, MPH


Peripheral lymphadenopathy without an obvious cause after the history and physical examination presents a diagnostic dilemma. There are many potential causes. Although biopsy is sometimes the best way to reach a definitive diagnosis, it should be used judiciously.

The general approach to the adult patient with peripheral lymphadenopathy is reviewed here. The evaluation and differential diagnosis of neck masses is presented separately. Evaluation and treatment of lymphadenopathy in children is also discussed separately. (See "Evaluation of a neck mass in adults" and "Differential diagnosis of a neck mass" and "Peripheral lymphadenopathy in children: Evaluation and diagnostic approach" and "Cervical lymphadenitis in children: Diagnostic approach and initial management" and "Peripheral lymphadenopathy in children: Etiology" and "Evaluation of inguinal swelling in children".)


The location of peripheral lymph node groups is shown schematically in the figures (figure 1 and figure 2). Normal lymph nodes are usually less than 1 cm in diameter and tend to be larger in adolescence than later in life.

A clinically useful approach is to classify lymphadenopathy as localized when it involves only one region, such as the neck or axilla, and generalized when it involves more than one region [1].


Lymphadenopathy can be caused by a vast array of diseases (table 1) and drugs (table 2) [2,3]. The location of lymphadenopathy can often be used to help identify specific etiologies (table 3).

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Literature review current through: Nov 2017. | This topic last updated: Dec 13, 2016.
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