LYMPHADENOPATHY

Differential diagnosis:

MALIGNANCY

• Hematologic malignancies
• Hodgkin's disease
• Non-Hodgkin's lymphoma
• Leukemia (acute & chronic)
• Waldenstrom's macroglobulinemia
• Multiple Myeloma (uncommon)
• Systemic mastocystosis

HYPERSENSITIVITY SYNDROMES

• Serum sickness
• Drugs (phenytoin, carbamazepine, primidone, gold, allopurinol, indomethacin, sulfonamides, etc.)
• Vaccination-related
• Graft-vs-host disease

INFECTIONS

• Viral (EBV, CMV, viral hepatitis, postvaccinial lymphadenitis, adenovirus, HSV, HIV, HTLV-1)
• Bacterial (cutaneous infections, cat-scratch fever, chancroid, meliodosis, tuberculosis, mycobacteria, syphilis, etc.)
• Chlamydia
• Lymphogranuloma venereum
• Protozoan, inc. toxoplasmosis
• Fungal, inc. histoplasmosis, coccidioidomycosis
• Rickettsial, inc. scrub typhus
• Helminthic, inc. filariasis

CONNECTIVE TISSUE DISEASES

• Rheumatoid arthritis
• Systemic lupus erythematosis
• Dermatomyositis
• Mixed Connective Tissue Disease
• Sjogren's syndrome

ATYPICAL LYMPHOPROLIFERATIVE DISORDERS

• Angiofollicular (giant) lymph node hyperplasia (Castleman's disease)
• Angioimmunoblastic lymphadenopathy with dysproteinemia
• Angiocentric immunoproliferative disorders
• Lymphomatoid granulomatosis
• Wegener's granulomatosis

GRANULOMATOUS DISEASES

• Infections (see above)
• Silicosis
• Berylliosis

OTHER

• Inflammatory pseudotumor of lymph nodes
• Histiocytic necrotizing lymphadenitis (Rosai-Dorfman disease)
• Vascular transformation of sinuses
• Progressive transformaiton of germinal centers)

(Source: Mayo Clin. Proc. 75:728, 2000--AFP)