Introduction: Lymph nodes are distributed throughout the body and play an important role as filters for exogenous and endogenous antigens, as well as in the formation of an immune response through activated lymphocytes and antibodies. In various conditions, such as infections, autoimmune diseases, lymphomas and metastatic carcinomas, their size can increase, a condition called lymphadenopathy (LAP)/adenopathy.
Materials and Methods: This article is based on a comprehensive review of 34 contemporary full-text articles in English. The information from them, after detailed examination, was analyzed and systematized in order to obtain a complete full-text publication on the general features of lymphadenopathy.
Results and Discussion: Lymphadenopathy is a frequent finding in clinical practice and may present as either localized or generalized. In the majority of cases, it is benign in nature and tends to resolve spontaneously. The distinction between a normal and an enlarged lymph node is influenced by both the patient’s age and the anatomical region involved. Approximately three-quarters of cases are localized, and more than half involve lymph nodes situated in the head and neck. A thorough medical history combined with a detailed physical examination remains fundamental for proper assessment. Nonetheless, imaging techniques often yield more precise data regarding lymph node size and morphology than clinical evaluation alone. Ultimately, histopathological analysis is regarded as the definitive diagnostic approach.
Conclusion: The cervical region, along with the maxillofacial region, are most often affected by LAP in all age groups. Thus, maxillofacial surgeons are faced with an extremely wide differential diagnosis, which requires them to know both the characteristics of LAP in general and the multitude of general and local diseases that can cause it. It is an important part of the interdisciplinary team performing the diagnosis and treatment of lymphadenopathy.
Gaddey HL, Riegel AM. Unexplained Lymphadenopathy: Evaluation and Differential Diagnosis. Am Fam Physician. 2016 Dec 01;94(11):896-903.
Maráz R, Venczel L, Sikorszki L, Ambrózay É, Serfőző O, Rajtár M, et al. [The importance of the extracapsular extension of the sentinel node metastasis in the surgical treatment of breast cancer]. Magy Seb. 2020 Mar;73(1):16-22.
Nikolaev NN, Yankov YG. Lymph nodes of the head and neck: in normal and pathological conditions. Varna Med Forum. 2023;12(1):69-74. doi: 10.14748/vmf.v12i1.9034.
Fijten GH, Blijham GH. Unexplained lymphadenopathy in family practice. An evaluation of the probability of malignant causes and the effectiveness of physicians' workup. J Fam Pract. 1988;27(4):373-6.
Dorfman T, Neymark M, Begal J, Kluger Y. Surgical Biopsy of Pathologically Enlarged Lymph Nodes: A Reappraisal. Isr Med Assoc J. 2018 Nov;20(11):674-8.
Yankov YG. Etiological bacterial spectrum of purulent inflammation of cervical lymph nodes in children with unknown causes of lymphadenopathy. Cureus. 2023;15(9):e46276. doi: 10.7759/cureus.46276.
Kumar S, Gupta P, Sharma V, Mandavdhare H, Bhatia A, Sinha S, et al. Role of Ultrasound-Guided Fine-Needle Aspiration Cytology of Omentum in Diagnosis of Abdominal Tuberculosis. Surg Infect (Larchmt). 2019 Jan;20(1):91-4. doi: 10.1089/sur.2018.165.
Yankov YG. The etiological bacterial spectrum of neck abscesses of lymph node origin – Gram-positive and Gram-negative bacteria. Cureus. 2023;15(10):e46940. doi: 10.7759/cureus.46940
Richner S, Laifer G. Peripheral lymphadenopathy in immunocompetent Adults. Swiss Med Wkly. 2 010;140:98–104. doi: 10.4414/smw.2010.12892.
Bazemore AW, Smucker DR. Lymphadenopathy and malignancy. Am Fam Physician. 2002;66:2103–10.
Habermann TM, Steensma DP. Lymphadenopathy. Mayo Clin Proc. 2000;75:723–32. doi: 10.4065/75.7.723.
Twist CJ, Link MP. Assessment of lymphadenopathy in children. Pediatr Clin North Am. 2002;49:1009–25. doi: 10.1016/s0031-3955(02)00038-x.
Kunitz G. An approach to peripheral lymphadenopathy in adult patients. West J Med. 1985;143:393–6.
Isaacs D. cervical infections. In: Elliott E, Gilbert R, Moyer V, Pichichero M, consultant editors, editors. Evidence-Based Pediatric Infectious Diseases. New Jersey: Blackwell; 2007. pp. 29–39.
Mohapatra PR, Janmeja AK. Tuberculous lymphadenitis. J Assoc Physicians India. 2009;57:585–90.
Screaton NJ, Berman LH, Grant JW. Head and Neck Lymphadenopathy: Evaluation with US-guided Cutting-Needle Biopsy. Radiology. 2002;224:75–81. doi: 10.1148/radiol.2241010602.
Shaha AR, Shah JP, Loree TR. Patterns of nodal and distant metastasis based on histologic varieties in differentiated carcinoma of the thyroid. Am J Surg. 1996;172:692–4. doi: 10.1016/s0002-9610(96)00310-8.
Yankov YG, Stoev LL, Dimanov SN, Stoeva MG, Stanislavova K. A rare case of papillary thyroid carcinoma in the thyroglossal duct cyst of a 14-year-old female patient with left thyroid hemiagenesis. Cureus. 2023;15(11):e49712. doi: 10.7759/cureus.49712.
Yankov YG, Dimanov SN, Stoev LL, Stanislavova K. Papillary thyroid carcinoma in thyroglossal duct cyst – a review article. Varna Med Forum. 2023;12(2):39-45. doi: 10.14748/vmf.v12i2.9333.
Bazemore AW, Smucker DR. Lymphadenopathy and malignancy. Am Fam Physician. 2002;66:2103–10.
Karnath BM. Approach to the patient with lymphadenopathy. Hospital Physician. 2005;41:29–33.
Viiala N, Gibson J [Internet] An approach to the assessment of lymphadenopathy: [cited 2007 Jan 10 ]. Available from: http://www.medicalobserver.com.au/news/an-approach-to-the-assessment-of-lymphadenopathy.
Yankov YG, Mechkarova ID. Etiological spectrum of odontogenic and non-odontogenic abscesses in oral and maxillofacial surgery. Scr Sci Med Dent. 2023;9(1):68-74. doi:10.14748/ssmd.v9i1.9130.
Yankov YG, Mechkarova ID. Microbiological spectrum, clinic and treatment of patients with phlegmons of the mouth floor. Int J Med Sci Clin Invent. 2023;10(5):6704-10. doi: 10.18535/ijmsci/v10i5.02.
Yankov YG, Stoev LL. Demographic distribution, etiological bacterial spectrum and antibacterial treatment of patients with odontogenic abscesses and phlegmons of the head and neck. J IMAB. 2023;29(4):5276-81. doi: 10.5272/jimab.2023294.5276.
Yankov YG. The etiological bacterial spectrum of neck abscesses of lymph node origin – Gram-positive and Gram-negative bacteria. Cureus. 2023;15(10):e46940. doi: 10.7759/cureus.46940.
Esen G. Ultrasound of superficial lymph nodes. Eur J Radiol. 2006;58:345–59. doi: 10.1016/j.ejrad.2005.12.039.
Khanna R, Sharma AD, Khanna S, Kumar M, Shukla RC. Usefulness of ultrasonography for the evaluation of cervical lymphadenopathy. World J Surg Oncol. 2011;9:29. doi: 10.1186/1477-7819-9-29.
Lioe TF, Elliott H, Allen DC, Spence RA. The role of fine needle aspiration cytology (FNAC) in the investigation of superficial lymphadenopathy; uses and limitations of the technique. Cytopathol. 1999;10:291–7. doi: 10.1046/j.1365-2303.1999.00183.x.
Dunphy CH, Ramos R. Combining fine-needle aspiration and flow cytometric immunophenotyping in evaluation of nodal and extranodal sites for possible lymphoma: A retrospective review. Diagn Cytopathol. 1997;16:200–6. doi: 10.1002/(sici)1097-0339(199703)16:3<200::aid-dc2>3.0.co;2-j.
Atula TS, Varpula MJ, Kurki TJ, Klemi PJ, Grénman R. Assessment of cervical lymph node status in head and neck cancer patients: palpation, computed tomography and low field magnetic resonance imaging compared with ultrasound-guided fine-needle aspiration cytology. Eur J Radiol. 1997;25:152–61. doi: 10.1016/s0720-048x(96)01071-6.
Burke C, Thomas R, Inglis C, Baldwin A, Ramesar K, Grace R, et al. Ultrasound-guided core biopsy in the diagnosis of lymphoma of the head and neck. A 9 year experience. Br J Radiol. 2011;84:727–32. doi: 10.1259/bjr/60580076.
Engert A, Eichenauer DA, Dreyling M, ESMO Guidelines. Hodgkin's lymphoma: ESMO Clinical Recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2010;21:v168–71. doi: 10.1093/annonc/mdq181.
Tilly H, Dreyling M, ESMO Guidelines. Diffuse large B-cell non-Hodgkin's lymphoma: ESMO Clinical Recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2009;20:110–112. doi: 10.1093/annonc/mdp145.
Email this article (Login required) 
