The evaluation of peripheral lymphadenopathy

Lymph node enlargement occurs in a large variety of diseases, which may be considered in groups defined by their characteristic presentations. A meticulous history and physical examination will generally define the disorder, which may then be confirmed by appropriate laboratory procedures. Biopsy of the node is generally the last step in the diagnostic algorithm and is definitive in 40 to 60 per cent of cases. For the hard, nontender, unilateral cervical node, a meticulous search for the primary lesion should precede the biopsy. Continued observation and occasionally reevaluation are important aspects of the care of all patients.