1 / 30

Understanding Lymphadenopathy: Diagnoses and Differential Considerations

Lymphadenopathy refers to abnormal changes in lymph nodes, which can result from various causes like infections or malignancies. Learn about the diagnostic process, characteristics of lymph nodes, and considerations for differentiating causes.

ekerby
Download Presentation

Understanding Lymphadenopathy: Diagnoses and Differential Considerations

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. LIMFADENOPATI IRZA WAHID SUBAGIAN HEMATOLOGI & ONKOLOGI MEDIK FK UNAND / RS DR M DJAMIL PADANG

  2. Definition • Lymph nodes that are abnormal in size, consistency or number  Generalized involvement of 3 or more noncontiguous lymph node areas.  Localized

  3. Non Burkitt’s Lymphoid generation Lymphocyte Lymphoplasmocytoid Plasma cell * AG INDEPENDENT DIFFRERENTIATION * STEM CELL / THYMUS * AG DEPENDENT DIFFRERENTIATION * NNLL, MALT

  4. Lymph nodes are populated predominantly by • - macrophages, • - dendritic cells, • - B lymphocytes, and • - T lymphocytes. • B lymphocytes are located primarily in the follicles and perifollicular areas, • T lymphocytes are found primarily in the interfollicular or paracortical areas of the lymph node.

  5. Lymphatic System • Network that filters antigens from the interstitial fluid • Primary site of immune response from tissue antigens • Lymphatic drainage in all organs of the body except brain, eyes, marrow and cartilage • 600 lymph nodes in body • Slow flow, low pressure system returns interstitial fluid to the blood system

  6. Jar. LimfoidPerifer Nnlldan Malt

  7. D I A G N O S I S • Anamnesis • history • age of the patient • The occurrence of fever, sweats, or weight loss • site of infection, a particular medication, atravel history. • Physical examination • Laboratoric test • Imaging studies to determine the extent and character of the lymphadenopathy • Histopatologic examination

  8. In young childrenpalpable lymphadenopathy is the rule. who are continuously undergoing exposure to new antigens, • * In fact, the absence of palpable lymphadenopathy would be considered abnormal • * In adults, lymph nodes larger than 1 to 2 cm in diameter are generally considered abnormal. • * However, lymph nodes 1 to 2 cm in diameter in the groin are sufficiently frequent to often be considered "normal.“

  9. more than two-thirds of patients with LAP have : • nonspecific causes or upper respiratory illnesses (viral or bacterial), • fewer than 1% have a malignancy • in another study :16% had a malignancy • (lymphoma or metastatic adenocarcinoma) • Thus, the vast majority of patients with lymphadenopathy will have a nonspecific etiology requiring few diagnostic tests.

  10. Lymph node character • Site • Size • Consistency • Pain with palpation

  11. Size • Greater than one centimeter generally considered abnormal • Exception inguinal area, lymph nodes commonly palpated (>1.5 cm) • Size does not indicate a specific disease process • Obese and thin population

  12. Pain….. • Indication of rapid increase in size: stretch of capsular shell • NOT useful in determining benign vs malignant state • Inflammation, suppuration, hemorrhage

  13. Consistency • Stone hard: typical of cancer usually metastatic • Firm rubbery: can suggest lymphoma • Soft: infection or inflammation • Suppurated nodes: fluctuant • Matting

  14. Site

  15. Post cervical: scalp, neck skin of arms thorax cervical and axillary nodes (lymphoma, head/neck ca)

  16. M I A M I MALIGNANT  lymphoma, metastatic INFECTION  acute, chronic AUTOIMMUNE DISEASE MISCELANOUS DISEASE  UNNUSUAL IATROGENIC

  17. Cancer • Hematologic malignancies:  Hodgkins, NHL,  acute and chronic leukemias, -  multiple myeloma • Metastatic solid tumor * head & neck cancer * breast, lung, * gi tract, genitourinary tract cancer * cancer of unknown primary

  18. I N F E C T I O N • Bacterial • Viral • Protozoan • Mycotic • Rickettsial (typhus) • Helminthic (filariasis)

  19. Bacterial • Staph/strep: cutaneous source, lymphadenitis • Cat scratch: bartonellahensalae, two weeks after inoculation • Mycobacterium: TB and non-tb, host characteristics

  20. VIRAL • EBV…mono spot test • CMV….cmv titers, immunsuppresed, transplant recipient, recent blood transfusion • HIV…IV drug use, high risk sexual behavior • Hepatitis….IV drug use • Herpes Zoster….superficial cutaneous nodules

  21. Protozoan • Toxoplasmosis: ELISA assay, intracellular protozoan toxoplasmosis gondii….bilateral, symmetrical, non-tender cervical adenopathy …consider undercooked meat, reactivation in immuncompromised host

  22. TERAPHYETIOLOGY

  23. T H A N K Y O U

More Related