MANAGEMENT OF LYMPHADENOPATHY
Rudy Afriant Bagian Ilmu Penyakit Dalam FKUA RSUP M Djamil Padang 2014
consistency or number • Generalized
• Lymph nodes that are abnormal in size.
marrow and cartilage • 600 lymph nodes in body • Slow flow. eyes. low pressure system returns interstitial fluid to the blood 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.
• Capsular shell • Fibroblasts and reticulin fibers • Macrophages • Dendritic cells • T cells • B cells
• Most cases benign. self limited illness • Primary or secondary manifestation of many illnesses • The CHALLENGE is to decide if it is representative of a serious illness…
Parameters to help distinguish between benign and serious illness
•Age •Character •Duration •Location
“Malignancy much more common in patients greater 50 yrs of age”
5 cm) Supraclavicula. hemorrhage
• • • Stone hard: typical of cancer usually metastatic Firm rubbery: can suggest lymphoma Soft: infection or inflammation
. epitrochlear > 5 mm is abnormal. iliaca . poplitea in any size are abnormal. Size does not indicate a specific disease process
• • • Indication of rapid increase in size: stretch of capsular shell NOT useful in determining benign vs malignant state Inflammation.Lymph node character
• • • • Greater than one centimeter generally considered --abnormal Exception inguinal area. suppuration. lymph nodes commonly palpated (>1.
Lymphadenopathy : .duration > 1 year usually benign
.onset < 2 weeks .
neck skin of arms thorax cervical and axillary nodes (lymphoma. head/neck ca)
Post cervical: scalp.
M ALIGNANT I NFECTION A UTOIMMUNE M ISCELLANEOUS/UNUSUAL I ATROGENIC
NON HODGKIN T-CELL
LYMPHADENOPATHY: Lymph nodes that are
abnormal in size.Conclussion
1. consistency or number 2. Parameters to help distinguish between benign and malignant lymphadenopathy: Age Character Duration Location 3. Differential diagnosis of lympahdenopathy are MALIGNANT Infection Autoimmune MISCELLANeous/UNUSUAL IATROGENIC