Lymph Node Enlargement (Lymphadenopathy): Symptoms, Complaints, Signs

Lymphadenopathy (lymph node enlargement) may be localized, regional, or generalized.Lymph nodes usually cannot be palpated in the tissues in a demarcated manner!In this case, the lymph node can be described as follows:

  • Soft
  • Sliding
  • Druckdolente (pressure painful)
  • Derb/hard
  • Caked with the environment
  • Environment reddened

Other clues

  • In children, normal cervical lymph nodes are often palpable.
  • Lymph nodes are considered abnormal:
    • Adult patients: > 1 cm (inguinal: > 1.5 cm).
    • Children: lymph node enlargements up to 2 cm often do not require further clarification, as they are mostly of reactive genesis.

Warning signs (red flags)

  • Anamnestic information:
    • Patient <30 years old → lymph node enlargement mostly benign (benign) in origin.
    • Patient > 50 years → lymph node enlargement mostly malignant (malignant) origin.
  • Persistent fever → think of leukemia (blood cancer) or lymphoma (lymphoma).
  • Generalized, persistent lymph node enlargement and weight loss and sweating in young patients → think of Pfeiffer’s glandular fever (infectious mononucleosis), lymphoma, or AIDS
  • Cervical (“belonging to the neck”) lymph node enlargement in middle-aged and older patients → exclusion of nasopharyngeal carcinoma (cancer of the nasopharynx) required
  • Spatial masses in the supraclavicular fossa (supraclavicular pit: pit formed inferiorly by the clavicle (collarbone) and medially by the lateral border of the sternocleidomastoid muscle) → malignant (malignant) lymphadenopathies (eg. E.g., Hodgkin’s lymphoma)Note: Patients > 40 years of age with space-occupying lesions in the subclavicular fossa have a 90% risk of malignancy (cancer); patients < 40 years of age have only a 25% risk.
  • Virchow lymph node involvement (supraclavicular (“above the clavicle) (left) in gastric carcinoma / stomach cancer (absolute rarity).

Note: “Any unexplained lymph node swelling persisting for more than four weeks or showing definite progression should be clarified by biopsy and histological examination” [S3 Guideline: Hodgkin Lymphoma]….