The Clinical Investigation of Lymphadenopathy in Primary Care Practice

ENLARGED lymph nodes occur in many conditions, either as a reaction to a local inflammatory process or associated with a systemic disease whose central focus is not in the lymph system. In some patients enlarged nodes are the initial or the most prominent manifestation of whatever disease is present and are the starting point for investigation. The algorithm presented here develops guidelines for evaluation of lymph node enlargement of the primary or secondary type. Scope and Limitations This algorithm is designed to be applied only to adolescents and adults, because a different array of diseases underlies enlarged lymph nodes in infants and children. It does not include therapy for any of the conditions detected. Following the model of protocols or clinical algorithms for primary care, it does not include diagnostic evaluation of rare diseases. On the other hand, nonspecific findings are included to alert the reader to consider more remote