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Peripheral lymphadenopathy in children: Etiology

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


Lymphadenopathy is common. It is usually not clinically important in and of itself. However, it can represent 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.

The causes of peripheral lymphadenopathy in children will be reviewed here (table 1A-B and table 2). The information is intended to provide a framework for the approach to the evaluation of peripheral lymphadenopathy in children and to supplement clinical judgment in the absence of research that directly addresses how children with unexplained lymphadenopathy should be evaluated.

The approach to the child with peripheral lymphadenopathy, cervical lymphadenitis, and the causes and evaluation of peripheral lymphadenopathy in adults are discussed separately. (See "Cervical lymphadenitis in children: Etiology and clinical manifestations" and "Peripheral lymphadenopathy in children: Evaluation and diagnostic approach" and "Evaluation of peripheral lymphadenopathy in adults".)


The location of peripheral lymph node groups is shown schematically in the figures (figure 1 and figure 2). Normal lymph nodes in most regions usually are less than 1 cm in their longest diameter; normal lymph nodes in the epitrochlear region usually are less than 0.5 cm in diameter, and normal lymph nodes in the inguinal region usually are less than 1.5 cm in diameter. Normal lymph nodes tend to be larger in childhood (ages 2 to 10 years) than later in life. Lymph nodes often are palpable in the inguinal region in healthy individuals, perhaps because chronic trauma and infection are so common in the lower extremities. Lymph nodes also may be palpable in the neck (particularly submandibular lymph nodes) because of previous head and neck infections.


Lymph node enlargement may be caused by [1]:

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Literature review current through: Nov 2017. | This topic last updated: Mar 30, 2017.
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