Condition | Selected clinical features that may be present |
Neoplastic | |
Primary | |
Hodgkin lymphoma | Usually manifests as cervical lymphadenopathy; adenopathy may be unilateral; respiratory distress can occur |
Non-Hodgkin lymphoma | Rapidly enlarging diffuse adenopathy, abdominal pain, vomiting; adenopathy is usually bilateral; respiratory distress can occur |
Metastatic | |
Acute lymphocytic or myelogenous leukemia | Ill appearance, bleeding, hepatosplenomegaly, anemia, thrombocytopenia; occipital nodes often prominent |
Neuroblastoma | Abdominal mass; opsoclonus-myoclonus, proptosis, periorbital ecchymoses, nasal obstruction, Horner syndrome, subcutaneous nodules, secretory diarrhea |
Rhabdomyosarcoma | Proptosis; nasal, aural, or sinus obstruction; Horner syndrome; hematuria; urinary obstruction; constipation |
Immunologic | |
Vasculitis syndromes (systemic lupus erythematosus, rheumatoid arthritis) | Patients may have generalized adenopathy during the acute phase of illness |
Serum sickness | Rash, splenomegaly, myalgia, arthritis |
Autoimmune hemolytic anemia | Lymphadenopathy coincides with hemolysis |
Chronic granulomatous disease | Recurrent infection, skin abscesses, suppurative adenitis |
Metabolic | |
Gaucher disease | Hepatosplenomegaly, anemia, thrombocytopenia, osteopenia |
Niemann-Pick disease | Hepatosplenomegaly, loss of neurologic function |
Drugs | |
Phenytoin, phenobarbital, carbamazepine, isoniazid, aspirin, barbiturates, penicillin, tetracycline, iodides, sulfonamides, allopurinol, and phenylbutazone | Severe maculopapular rash, fever, hepatosplenomegaly, jaundice, anemia, leukopenia, and plasmacytosis occurring during or after the lymphadenopathy |
Miscellaneous | |
Sarcoidosis | Multisystem granulomatous disease; generalized adenopathy with prominent cervical involvement |
Hemophagocytic lymphohistiocytosis | Fever, hepatosplenomegaly, neurologic symptoms, rash |
Castleman disease | Fever, hepatosplenomegaly, polyclonal hypergammaglobulinemia |
Langerhans cell histiocytosis | Rash (brown to purplish papules), mucosal lesions, lytic bone lesions, proptosis, diabetes insipidus |
Kikuchi-Fujimoto disease | Cervical and supraclavicular adenopathy, fever, fatigue, weight loss, anemia, and leukopenia |
Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy) | Chronic bilateral cervical adenopathy is characteristic; other nodal groups are involved in most cases; fever, anemia, leukocytosis, elevated ESR, and hypergammaglobulinemia |
Hyperthyroidism | Tachycardia, hypertension, diaphoresis, weight loss, goiter, hyperreflexia |
Papular acrodermatitis (Gianotti-Crosti syndrome) | Rash on face, buttocks, limbs, palms, and soles; hepatomegaly |
Progressive transformation of germinal centers | Found in 10% of nodes with reactive hyperplasia; sometimes associated with prior diagnosis of Hodgkin lymphoma and rarely before the diagnosis of Hodgkin lymphoma |
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