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Haem Exam

Cervical Lymphadenopathy

February 15th, 2021


Lymphadenopathy refers to enlargement of the lymph nodes, which is often painful. It is important to carefully assess for lymph node enlargement, as this suggests infective, inflammatory or malignant pathology.
  • How to Perform

  • Using the pulps of the fingers, gently palpate each of the lymph node groups within the cervical and axillary regions.
  • Feel For

  • Size - normally <10mm
  • Tenderness
  • Consistency - hard (metastasis), rubbery (lymphoma), soft (reactive)
  • Mobility - mobile or tethered to underlying structures
  • Causes of Lymphadenopathy

  • Bacterial infection - localised infection, skin infection, tuberculosis / MAC, syphilis, cat-scratch disease
  • Viral infection - EBV, CMV, HIV, herpes simplex, rubella
  • Parasitic infection - toxoplasmosis
  • Malignancy - lymphoma, leukaemia, metastasis
  • Inflammatory disorders - lupus, rheumatoid arthritis
  • Sarcoidosis
  • Medications - allopurinol, atenolol, cephalosporins, penicillin, phenytoin, carbemazepine
  • Storage disorders
  • Benign idiopathic lymphadenopathy

Cervical Lymph Nodes

Submental nodes - immediately below the chinTeeth, oral mucosa, tongue
Submandibular nodes - Along the angle of the mandibleFloor of mouth
Anterior cervical nodes - over the sternocleidomastoidPosterior pharynx, tonsils, parotid
Posterior cervical nodes - posterior to sternocleidomastoidsScalp, posterior neck
Suboccipital nodes - below the occiputInferior scalp
Preauricular nodes - Anterior to the pinnaEyelids, conjunctivae
Postauricular nodes - posterior to the pinnaExternal auditory meatus, pinna, scalp
Right supraclavicular node - in the right supraclavicular fossaMediastinum, lungs, oesophagus
Left supraclavicular node (Virchow's node) - in the left supraclavicular fossaChest, abdomen
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