Infections, cat-scratch disease, lymphoma, breast cancer, silicone implants, brucellosis, melanoma Lymphoma, thoracic or retroperitoneal cancer, bacterial or fungal infection Lung, retroperitoneal or gastrointestinal cancer Tuberculosis, lymphoma, head and neck malignancyĮyelids and conjunctivae, temporal region, pinna
#Shotty node skin#
Scalp and neck, skin of arms and pectorals, thorax, cervical and axillary nodes Mononucleosis syndromes, Epstein-Barr virus, cytomegalovirus, toxoplasmosiss Lower lip, floor of mouth, tip of tongue, skin of cheek Infections of head, neck, sinuses, ears, eyes, scalp, pharynx Tongue, submaxillary gland, lips and mouth, conjunctivae Mexico, Peru, Chile, India, Pakistan, Egypt, Indonesia Southeast Asia, India, northern AustraliaĪfrican trypanosomiasis (sleeping sickness)Īmerican trypanosomiasis (Chagas' disease)Įast Africa, Mediterranean, China, Latin America HIV, syphilis, herpes simplex virus, cytomegalovirus, hepatitis B infectionįishermen, fishmongers, slaughterhouse workersĪrizona, southern California, New Mexico, western Texas 7 In addition, there may be some risk of sinus tract formation, depending on the underlying pathology. Fine-needle aspiration is occasionally considered an alternative to excisional biopsy but often yields a high number of nondiagnostic results because of the small amount of tissue obtained and the inability to examine the architecture of the gland. Patients with localized lymphadenopathy and a worrisome clinical picture or patients with generalized lymphadenopathy will need further diagnostic evaluation that often includes biopsy ( see the “unexplained” branch of the algorithm). In patients with unexplained localized lymphadenopathy and a reassuring clinical picture, a three- to four-week period of observation is appropriate before biopsy. A subset of patients will either have unexplained lymphadenopathy after the initial clinical evaluation or have a presumptive diagnosis that is made in the “diagnostic” or “suggestive” branches of the algorithm and is not confirmed by test results or by the clinical course.
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