An abnormal increase in size or altered consistency of lymph nodes. It is manifestation of regional or systemic disease.

Common diseases associated with lymph node enlargement:

• Infectious diseases

- viral diseases; HIV

- bacterial infections; pyogenic. tuberculosis

• Malignant diseases

- haematological; Hodgkin's and non-Hodgkin's lymphoma

- metastatic tumours to lymph nodes; head and neck, breast, prostate

• Inimunological disease

- connective tissue disorders.

Clinical Features

Clinical features depend on underlying cause.

Investigations

Careful clinical examination is vital before ordering investigations, e.g. axillary lymph nodes in presence of a breast mass points to cancer of the breast.

• Full haemogram

• Chest X-ray

• Blood for HIV test

• Bone marrow

• Lymph node biopsy.

About 25% of patients will have non-diagnostic results from the biopsy. Repeat biopsy should be performed if enlarged lymph nodes and symptoms persist.

Management

Further diagnostic evaluation depends on the initial results e.g. thorough ENT work-up if biopsy indicates a secondary from the post-nasal space. Specific management depends on the specific cause of lymphadenopathy.