SPOTTERS MEDICINE
CERVICAL LYMPH ADENOPATHY
🔹
Definition:
Cervical lymph nodes are
the lymph nodes located in the neck region, responsible for draining the
head, face, scalp, oral cavity, pharynx, and nearby structures.
🔹
Classification of Cervical Lymph Nodes:
🔸 Based
on Location (Anatomical Groups):
1. Submental –
under the chin
2. Submandibular –
under the jaw
3. Preauricular – in
front of the ear
4. Postauricular
(Mastoid) – behind the ear
5. Occipital –
back of the scalp
6. Superficial
cervical – along external jugular vein
7. Deep
cervical (jugulodigastric, jugulo-omohyoid) – along internal
jugular vein
8. Posterior
cervical – along spinal accessory nerve
9. Supraclavicular –
above the clavicle
🔹
Drainage Areas:
|
Node Group |
Drains |
|
Submental |
Lower lip, floor of mouth, tip of tongue |
|
Submandibular |
Cheek, lateral tongue, upper lip, gums |
|
Jugulodigastric |
Tonsils, pharynx |
|
Posterior cervical |
Scalp, neck skin, upper thorax |
|
Supraclavicular |
Thorax, abdomen (Virchow’s node on left) |
🔹
Clinical Examination:
- Inspection:
swelling, location, overlying skin changes
- Palpation:
- Size
- Tenderness
- Consistency
(soft, firm, hard)
- Mobility
- Fixation
to surrounding structures
- Number
and grouping
🔹
Causes of Cervical Lymphadenopathy:
🔸
Infectious:
- Bacterial:
Tuberculosis, Staphylococcus, Streptococcus
- Viral:
Infectious mononucleosis, HIV, EBV
- Fungal
or Parasitic
🔸
Neoplastic:
- Primary
lymphomas (Hodgkin’s, Non-Hodgkin’s)
- Metastasis
from head & neck cancers, thyroid, breast, lung
- Virchow’s
node – gastric carcinoma metastasis
🔸
Autoimmune:
- Systemic
lupus erythematosus (SLE)
- Sarcoidosis
- Rheumatoid
arthritis
🔸
Miscellaneous:
- Kikuchi
disease
- Castleman
disease
- Drug-induced
lymphadenopathy (e.g., phenytoin)
🔹
Investigations:
- CBC,
ESR, peripheral smear
- Chest
X-ray, Mantoux test (for TB)
- FNAC
(Fine Needle Aspiration Cytology)
- Excisional
biopsy (if FNAC inconclusive)
- Imaging:
Ultrasound, CT/MRI neck
- Serology
(HIV, EBV, ANA)
🔹
Treatment:
- Infectious:
Antibiotics, antitubercular therapy
- Malignancy:
Chemotherapy, radiotherapy, surgical excision
- Supportive:
Analgesics, warm compress for acute infections
🔹 Red
Flag Signs (Need Immediate Evaluation):
- Hard,
fixed, painless nodes
- Supraclavicular
lymphadenopathy
- Persistent
>2–4 weeks
- Associated
weight loss, fever, night sweats
🔹
Prognosis:
- Good
in infectious causes
- Guarded
in malignancy depending on stage and spread
- Requires
proper evaluation to prevent delayed diagnosis
DR.C.GANESAN
M.D.,
PROFESSOR
OF MEDICINE
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