Cervical lymphadenopathy

D/D, Investigations

1. CERVICAL LYMPHADENOPATHY Zaryab Ghauri Final Year Batch E

2. I nfective : Age < 10years Painful lump jus below the angle of jaw Child may snore at night, Difficulty in breathing, Nasal speech, Recurrent chest infections Systemic Effects: Feels ill sore throat pyrexia and doesn’t want to eat Malnourished child, Cold, damp houses

3. Tuberculous lymphadenitis: Children, young and elderly Lump with gradual appearance, With or without pain Neck movement and swallowing painful Anorexia and weight loss If breaks down into abscess it increases in size, become painful, discoloration of overlying skin BCG vaccination Any Family member has TB Poor socioeconomic status

4. Primary Reticuloses : Common in children and young adults Painless lump which Grow slowly Systemic: Malaise, weight loss and pallor Itching of the skin (unexplained but distinct) Periodic fever and rigors Pains in bones Venous congestion in the neck ( large lymph gland mass occlude superior vena cava)

5. Metastatic lymphadenopathy : Occur in patients > 50 years Painless lump Grow slowly and new lumps may appear Symptoms of Primary lesion In the head and neck: sore tongue; hoarse voice In the chest: cough; haemoptysis In the abdomen: dyspepsia; abdominal pain Head and neck cancers do not cause anorexia or weight loss

6. Investigation Laboratory investigations Blood film exam Diagnosis of glandular fever or leukemia LFT & RFT: helpful in identify associated underlying systemic disorders Serological tests: HIV & syphilis LN biopsy: Histological Diagnosis (particularly in Hodg.and non- Hodg . lymphoma)

7. Investigation Radiological investigations X-ray: TB shows typical spotty calcification Chest X-ray: shows enlarged mediastinal nodes or primary occult tumor of the lung U/S: helpful in evaluating the changes in the lymph nodes CT scan of chest & abdomen in case of supraclavicular adenopathy , associated with serious underlying disease

8. Thank You 