![]() ![]() #SWOLLEN NECK LYMPH NODES SKIN#Scalp and neck, skin of arms and pectorals, thorax, cervical and axillary nodes Mononucleosis syndromes, Epstein-Barr virus, cytomegalovirus, toxoplasmosiss Lower lip, floor of mouth, tip of tongue, skin of cheek Infections of head, neck, sinuses, ears, eyes, scalp, pharynx ![]() Tongue, submaxillary gland, lips and mouth, conjunctivae Mexico, Peru, Chile, India, Pakistan, Egypt, Indonesia ![]() Southeast Asia, India, northern AustraliaĪfrican trypanosomiasis (sleeping sickness)Īmerican trypanosomiasis (Chagas' disease)Įast Africa, Mediterranean, China, Latin America HIV, syphilis, herpes simplex virus, cytomegalovirus, hepatitis B infectionįishermen, fishmongers, slaughterhouse workersĪrizona, southern California, New Mexico, western Texas 7 In addition, there may be some risk of sinus tract formation, depending on the underlying pathology. Fine-needle aspiration is occasionally considered an alternative to excisional biopsy but often yields a high number of nondiagnostic results because of the small amount of tissue obtained and the inability to examine the architecture of the gland. Patients with localized lymphadenopathy and a worrisome clinical picture or patients with generalized lymphadenopathy will need further diagnostic evaluation that often includes biopsy ( see the “unexplained” branch of the algorithm). In patients with unexplained localized lymphadenopathy and a reassuring clinical picture, a three- to four-week period of observation is appropriate before biopsy. A subset of patients will either have unexplained lymphadenopathy after the initial clinical evaluation or have a presumptive diagnosis that is made in the “diagnostic” or “suggestive” branches of the algorithm and is not confirmed by test results or by the clinical course. ![]()
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