The M.I.A.M.I. Approach to Deciphering Lymphadenopathy

Guest: Carrie A. Thompson, M.D. (@CaThompsonMD)

Host: Darryl S. Chutka, M.D. (@ChutkaMD)

It’s common for a patient to see their primary care provider after they’ve discovered an enlarged lymph node and they’re usually concerned that it represents a serious illness. Fortunately, in most cases it’s due to a benign cause and most patients can be reassured once we perform a careful history and physical examination. However, on occasion lymphadenopathy can represent serious disease. Carrie Thompson, M.D. a hematologist, at Mayo Clinic’s Rochester campus joins us to discuss how to tell when lymphadenopathy is due to a benign or serious cause. We’ll review the characteristics of both benign and malignant lymph nodes and the evaluation which should be done both for an enlarged solitary lymph node as well as generalized lymphadenopathy.

Specific topics discussed:

• Prevalence of malignancy in patients who seek a medical evaluation for lymphadenopathy
• Categories of disease which can have associated lymphadenopathy
• Characteristics of benign and malignant lymph nodes
• Diagnostic approach for a solitary enlarged lymph node
• Diagnostic approach or multiple or generalized lymphadenopathy
• Fine needle aspirate vs. excisional biopsy for evaluation of lymphadenopathy

Additional resources:

• Gaddey, HL. Riegel, AM. Unexplained lymphadenopathy: evaluation and differential diagnosis. Am Fam Physician.2016 December 1; 94(11): 896-903. https://www.aafp.org/afp/2016/1201/p896.html

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