[Examining the lymph nodes]

Abstract

Enlarged lymph nodes occur frequently and imply a benign or systematic disorder. In primary care, only 1% of patients with an unexplained lymphadenopathy have a malignancy. In the case of unexplained lymphadenopathy the most important diagnostic dilemma is whether biopsy should be applied. In young patients the necessity of lymph node biopsy can be accurately predicted using the following parameters: abnormal chest X-ray; lymph node > 2 cm and ear, nose and throat symptoms. In adults the necessity of biopsy may be reliably predicted using the following parameters: age; lymph node tenderness; lymph node size; consistency, presence of supraclavicular lymph nodes and generalised pruritus.