Hematology and Oncology Book

Cancer

Lymphatic Disorders

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Lymphadenopathy of the Head and NeckAka: Head and Neck Lymphadenopathy

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  1. See Also
    1. Neck Masses in Adults
    2. Neck Masses in Children
    3. Submandibular Exam
    4. Oral Exam
    5. Lip Exam
    6. Virchow's Node
  2. Submandibular Nodes (below angle of jaw)
    1. Drainage Pattern
      1. Tongue
      2. Submaxillary gland
      3. Submental node drainage
      4. Lip and Mouth mucosa
      5. Medial Conjunctiva
    2. Lymphadenopathy Causes (Infections of head and neck)
      1. Acute Sinusitis
      2. Chronic Sinusitis
      3. Otitis Media
      4. Conjunctivitis
      5. Tinea Capitis
      6. Pharyngitis
  3. Submental Nodes (below chin)
    1. Drainage Pattern
      1. Lower lip
      2. Floor of Mouth
      3. Tip of Tongue
      4. Skin of Cheek
    2. Lymphadenopathy Causes
      1. Mononucleosis (Epstein-Barr Virus)
      2. Cytomegalovirus
      3. Toxoplasmosis
  4. Jugular Nodes (anterior border of sternocleidomastoid)
    1. Drainage Pattern
      1. Tongue (except apex)
      2. Tonsil
      3. Ear pinna
      4. Parotid Gland
    2. Lymphadenopathy Causes
      1. Pharyngitis
      2. Rubella
  5. Posterior Cervical Nodes (behind sternocleidomastoid)
    1. Drainage Pattern
      1. Scalp
      2. Neck
      3. Arm and pectoral skin
      4. Thorax
      5. Cervical and axillary node drainage
    2. Lymphadenopathy Causes
      1. Tuberculosis
      2. Lymphoma (especially Hodgkin's Lymphoma)
      3. Head and neck cancer
      4. African Trypanosomiasis (Winterbottom's Sign)
  6. Suboccipital nodes (base of skull, below occiput)
    1. Suboccipital Lymphadenopathy may causes Headache
    2. Drainage Pattern
      1. Back of Scalp and Head
    3. Lymphadenopathy Causes
      1. Local infection
      2. Tinea Capitis
      3. Pediculosis capitis (Lice)
      4. Seborrheic Dermatitis
      5. Secondary Syphilis
      6. Neoplasm
  7. Postauricular nodes (behind pinna of ear)
    1. Drainage Pattern
      1. External auditory meatus
      2. Posterior Ear pinna
      3. Temproal Scalp
    2. Lymphadenopathy Causes (Local infection)
      1. Otitis Externa
      2. Tinea Capitis
      3. Secondary Syphilis
      4. Rubella
  8. Preauricular nodes (anterior to ear tragus)
    1. Drainage Pattern
      1. Lateral Eyelids
      2. Palpebral Conjunctiva
      3. Temporal skin
      4. Anterior Ear pinna
      5. External auditory canal
    2. Lymphadenopathy Causes
      1. Local infection
        1. Rodent ulcer
        2. Epithelioma
        3. Chancre on face
        4. Erysipelas
        5. Ophthalmic Herpes Zoster
        6. Rubella
        7. Trachoma
      2. Viral Conjunctivitis
        1. Epidemic Keratoconjunctivitis
        2. Adenoidal-pharyngeal-Conjunctivitis Virus
      3. Not usually seen in Bacterial Conjunctivitis
      4. Chronic granulomatous Conjunctivitis
        1. Parinaud's oculoglandular syndrome
          1. Complication of Cat Scratch Disease (Tularemia)
        2. Chancre (Syphilis)
        3. Tuberculosis
        4. Leptotrichosis (Leptothrix Infection)
        5. Gonorrhea ophthalmia
        6. Sporotrichosis
        7. Glanders
        8. Chancroid
        9. Lymphogranuloma venereum
        10. Chagas Disease
  9. Generalized Acute Cervical Lymphadenopathy Causes
    1. Secondary Syphilis
    2. Rubella
    3. Infectious Mononucleosis (Epstein Barr Virus)
    4. Generalized Furunculosis
    5. Lice infestation
    6. Serum Sickness
    7. Severe drug allergy (e.g. Penicillin)
    8. Cat Scratch Disease
    9. Cytomegalovirus
    10. Adenovirus
    11. Toxoplasmosis
    12. African Trypanosomiasis (African Sleeping Sickness)
    13. Kala Azar
    14. Scrub Typhus
  10. References
    1. Degowin (1987) Diagnostic Exam, Macmillan, p. 222
    2. Dornbland (1992) Adult Ambulatory Care, p. 662-7
    3. Ferrer (1998) Am Fam Physician 58(6):1313
    4. Lee (1999) Wintrobe's Hematology, p. 1826-30
    5. Wilson (1991) Harrison's Internal Medicine, p. 354-6

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