Cervical Lymphadenopathy

Cervical lymphadenopathy (CL) is an abnormal swelling or enlargement of the lymph nodes in the neck. The cervical lymph nodes drain the scalp, skin, oral cavity, larynx, and neck. The most common causes of CL are; infection, malignancy, bacterial pharyngitis, dental abscess, ear infections, infectious mononucleosis, head and neck cancer especially in older patients with history of smoking, thyroid cancer, lymphoma, and tuberculosis (Magsi, Jamro, Shaikh, & Sangi, 2013). The workup for CL consist of a comprehensive history and physical examination, laboratory tests, imaging studies, and sometimes tissue biopsy may be indicated. The history should focus upon demographic information (sex, race, ethnicity, age, occupation, place of residence), the clinical course (acute, subacute, or chronic), constitutional symptoms (fever, night sweats, fatigue, weight loss, sore throat), exposure history (pets, medications, infectious disease), high risk behavior (sexual behavior and substance abuse), family history (malignancy, tuberculosis and others). The physical exams should assess the lymph nodes for size, tenderness, consistency, location, and fixation. Cervical nodes greater than 1cm in adults are considered abnormal. Imaging can identify the size and distribution of the node
Enlarged cervical lymph nodes are common in pediatrics, however, over 80% cases of lymph node swelling is benign. This figure decreases considerably with age, to the extent that a malignant cause is found in over 60% of patients’ age 50 years and older. However, if there is a suspicion of malignancy in a pediatrics, the most frequent causes in children during the first 6 years of life are acute leukemia, neuroblastoma, rhabdomyosarcoma and non-Hodgkin lymphoma. After 6years to adolescence, Hodgkin’s disease is the leading malignant cause associated with CL. In adult patient with CL, malignancy is the greatest concern (Lang, & Kansy,