Cervical LAD

Describe location, size, consistency, border, mobility, and tenderness

• Location
• 2S, 3C, TM, Number
  • Size
    • Palpable = enlarged
    • ≤ 2 cm: infection

    • 2 cm: tumor or Lymphoma

  • Shape
    • Round or ovoid: normal
  • Contour
    • Discrete border
    • Conglomerates
  • Consistency
    • Soft: infection
    • Robbery (shotty):Lymphoma, normal
    • Firm: tumor
  • Tenderness
    • Tender: infection
    • Non-tender: tumor, normal
  • Mobility
    • Non-mobile: tumor
    • Mobile: Lymphoma, normal
  • Erythema in affected area
  • Number

In children, peripheral lymphadenopathy is normal

Worrisome features:

• systemic symptoms (such as fever, night sweats, or weight loss)
• supraclavicular nodes
• fixed nodes
• non-tender nodes
• nodes >2cm in diameter in size that are getting bigger even with antibiotics
• abnormal investigations
  • CBC with cytopenias in more than one cell line
  • persistently high ESR/CRP (inflammatory markers)
  • abnormal chest x-ray showing a mediastinal mass or hilar adenopathy