Cervical lymphadenopathy

Published on February 28, 2017   43 min

Other Talks in the Series: Oral & Maxillofacial Medicine

0:00
Hello, welcome to this lecture which is on "Cervical Lymphadenopathy". My name is Graham Ogden, Professor of Oral Surgery at the University of Dundee.
0:13
The lymphoid tissue in this region of the body is found principally in the tonsils situated between the pillars of the fauces. Secondly, lying in the posterior tongue also known as the lingual tonsil. And thirdly, in the posterior wall of the pharynx, commonly referred to as the adenoids. Together these form something known as "Waldeyer's ring". In addition to that, there are discrete nodes, which we refer to as 'named' nodes, scattered in the orofacial region, which we will come on to describe in a few minutes. It is interesting to note that at least 25% of all the nodes in the body are connected to the cervical nodes. Hence, it is perhaps not so surprising that many diseases can present in the head and neck region.
1:11
When presented with a patient in which you wish to examine the lymphadenopathy in this region, it is important to palpate both the anterior and posterior cervical nodes. Where you suspect that there is systemic disease then it may be prudent to also palpate both the liver and the spleen. For example, where there is evidence of generalised lymphadenopathy. Please note, that we can also see discrete swellings caused by expansion of the salivary gland, the thyroid gland, and other structures in that region.
1:54
Age of presentation can also help to prompt the likely differential diagnosis. So for example, in somebody under the age of 20, for example, a child, then the most likely cause of cervical lymphadenopathy is going to be a common cold or very rarely Kawasaki disease, which we will go on to describe later in this lecture. If we are dealing with a teenager, then again most likely to be due to a common cold. But there can be glandular fever- like syndromes and, of course, there is also the possibility of HIV disease. If a patient is greater than 20 years of age, so for example, an adult in their third or fourth decade, then the most likely causes are, once again, going to be common cold, possibly glandular fever- type syndromes, and also HIV infection. After the fourth decade, the most likely reasons for swelling due to enlarged lymph nodes in that region are again common cold, but also malignant disease. Having said that, of course, malignant disease can present in those under that age and should always be considered in your differential diagnosis.
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Cervical lymphadenopathy

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