Lymph nodes & spleen, nonlymphoma
Lymph nodes-inflammatory / reactive disorders
Acute nonspecific lymphadenitis
Author: Jayalakshmi Balakrishna, M.D.
Last author update: 1 April 2017
Last staff update: 5 November 2024 (update in progress)
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: Acute nonspecific lymphadenitis
Table of Contents
Definition / general | Essential features | Terminology | ICD coding | Epidemiology | Sites | Pathophysiology | Etiology | Clinical features | Diagnosis | Laboratory | Prognostic factors | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Positive stains | Differential diagnosis | Additional references | Board review style question #1 | Board review style answer #1Cite this page: Balakrishna J. Acute nonspecific lymphadenitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphnodesacutenonspecificlymphadenitis.html. Accessed December 2nd, 2024.
Definition / general
- Acute inflammation of lymph nodes
Essential features
- Enlarged and painful, tender lymph nodes
- Microscopic examination, if performed, will show sinus dilatation followed by accumulation of neutrophils, vascular dilatation and edema of the capsule
Terminology
- Acute nonspecific lymphadenitis, nontuberculous lymphadenitis
ICD coding
Epidemiology
- Common, mostly affects children
Sites
- Cervical lymph nodes are commonly affected
- Acute nonspecific mesenteric lymphadenitis is also a relatively common in children
Pathophysiology
- Acute inflammation of the involved lymph node / nodes due to an infectious or inflammatory etiology
Etiology
- Most commonly due to viral infections
- Most common bacterial causes are Staphylococcus aureus and beta hemolytic Streptococcus
- Inflammation of the draining sites or direct inflammation of the lymph nodes can be the cause
Clinical features
- Enlarged painful / tender lymph nodes, redness of overlying skin, low grade fever, malaise
Diagnosis
- Clinical examination, exclude specific causes
Laboratory
- Depending on the cause, CBC may show leukocytosis with neutrophilia or lymphocytosis, elevated ESR and bacterial / viral confirmatory tests may be positive
Prognostic factors
- Good prognosis
Treatment
- Treat the underlying cause, supportive therapy
Gross description
- Enlarged lymph node
- If bacterial infection, there can be suppuration leading to necrosis and abscess formation
Microscopic (histologic) description
- Biopsy is rarely performed
- Microscopic examination, if performed, will show sinus dilatation followed by accumulation of neutrophils, vascular dilatation and edema of the capsule
- If bacterial origin, suppurative inflammation is present
- Necrotizing inflammation can be seen in bubonic plague and tularemia, Still disease and Kikuchi necrotizing lymphadenitis
Microscopic (histologic) images
Images hosted on other servers:
Acute lymphadenitis
Cytology description
- Mixed small and large lymphocytes admixed with neutrophils
Positive stains
- Varies by etiology
- Gram stain highlights bacteria, if present
Differential diagnosis
- Specific causes should be ruled out
- Suppurative lymphadenitis caused by bacterial infections, mesenteric lymphadenitis, lymphogranuloma venereum, cat scratch disease, bubonic plague, tularemia, anthrax, typhoid fever, melioidosis
Additional references
Board review style question #1
23 year old woman presents with tender right cervical lymph node enlargement. She also complains of low grade fever and feeling tired. On examination she is found to have three 4 mm red papules on her right shoulder. On further enquiry she informs that she owns two cats. What is the best confirmatory test at this point?
A. Biopsy of the lymph node
B. Biopsy of the skin lesion
C. PCR
D. Serology
A. Biopsy of the lymph node
B. Biopsy of the skin lesion
C. PCR
D. Serology
Board review style answer #1
D. Serology. Serology for IgG and IgM antibodies for Bartonella henslae is confirmatory for cat scratch disease. Biopsy is rarely indicated. If performed, a biopsy will show lymphoid hyperplasia, granuloma formation, stellate abscesses and vascular proliferation depending on the stage of the disease. PCR can be done on biopsy specimen to confirm the diagnosis.
Comment Here
Reference: Acute nonspecific lymphadenitis
Comment Here
Reference: Acute nonspecific lymphadenitis
