Lymphadenopathy Follow-up

Author: Vikramjit S Kanwar, MD, MBA, MRCP(UK), FAAP; Chief Editor: Russell W Steele, MD more...

Updated: Mar 4, 2010

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Further Inpatient Care
Further Outpatient Care
Inpatient & Outpatient Medications
Transfer
Complications
Prognosis
Patient Education
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Further Inpatient Care

Additional inpatient treatment depends on establishing the diagnosis and determining management based on that diagnosis.

Further Outpatient Care

Further outpatient treatment depends on establishing a diagnosis and determining management of that diagnosis.

Inpatient & Outpatient Medications

Inpatient and ambulatory medications depend on the specific underlying etiology of the lymphadenopathy.

Transfer

Transfer of the patient usually depends on the specific diagnosis. Patients who develop superior vena cava syndrome with either respiratory symptoms or obstruction to blood flow require emergency medical care and may require transfer to a tertiary care center.

Complications

Complications are usually related to the specific underlying disorder causing the lymphadenopathy; however, the lymphadenopathy itself can cause potentially serious complications.

Mediastinal adenopathy can result in several potentially life-threatening complications. Recognition of these complications is important because mediastinal adenopathy cannot be directly assessed clinically and therefore may be easily missed.
Mediastinal adenopathy can cause superior vena cava syndrome with obstruction of blood flow; bronchial or tracheal obstruction with cough, wheezing, and ultimately respiratory tract obstruction (which can be life threatening); and dysphagia from esophageal compression. Occasionally, erosion of a node into a bronchus or trachea can result in hemoptysis.
When the diagnosis of an underlying malignancy is missed, serious metabolic complications can occur. These include uric acid nephropathy, hyperkalemia, hypercalcemia, hypocalcemia, hyperphosphatemia, and acid renal failure.
Abdominal adenopathy can cause abdominal or back pain, constipation, and urinary frequency. Intestinal obstruction caused by intussusception can be life threatening.

Prognosis

The prognosis of lymphadenopathy almost entirely depends on the underlying etiology. Patients with specific complications, such as superior vena cava syndrome, are at risk unless this specific complication is managed. Their prognosis is dependent on the management of the neoplastic process resulting in superior vena cava syndrome.

Patient Education

Patient and family education depends on the specific etiology of the lymphadenopathy.

Contributor Information and Disclosures

Author

Vikramjit S Kanwar, MD, MBA, MRCP(UK), FAAP Associate Professor of Pediatric Hematology and Oncology, Department of Pediatrics, Albany Medical Center; Faculty, Alden March Bioethics Institute

Vikramjit S Kanwar, MD, MBA, MRCP(UK), FAAP is a member of the following medical societies: American Academy of Pediatrics, American Society of Pediatric Hematology/Oncology, Children's Oncology Group, and Royal College of Physicians of the United Kingdom

Disclosure: Nothing to disclose.

Coauthor(s)

Richard H Sills, MD Professor of Pediatrics, Upstate Medical University

Richard H Sills, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Society of Hematology, and American Society of Pediatric Hematology/Oncology

Disclosure: Nothing to disclose.

Specialty Editor Board

Gary J Noel, MD Professor, Department of Pediatrics, Weill Cornell Medical College; Attending Pediatrician, New York-Presbyterian Hospital

Gary J Noel, MD is a member of the following medical societies: Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Larry I Lutwick, MD Professor of Medicine, State University of New York Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus

Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Helen SL Chan, MBBS, FRCP(C), FAAP Senior Scientist, Research Institute; Professor, Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Canada

Helen SL Chan, MBBS, FRCP(C), FAAP is a member of the following medical societies: American Academy of Pediatrics, American Association for Cancer Research, American Society of Hematology, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Stephanie Jorgensen, MD, to the original writing and development of this article.

References

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A lymph node biopsy is performed. Note that a marking pen has been used to outline the node before removal and that a silk suture has been used to provide traction to assist the removal.

A lymph node after removal by means of biopsy, which was performed completely under a local anesthetic technique.

A gross image of a node following excision. The cut surface of the node shows the typical fish-flesh appearance seen with lymphoma.

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