Imaging of cervical lymphadenopathy

The identification and classification of cervical lymphadenopathy can be a challenging task for the general radiologist. Patients with a wide range of clinical presentation and disease states are often referred for imaging, although evaluation and staging of head and neck cancer is the most common indication. In addition to metastatic squamous carcinoma of the upper aerodigestive tract, the differential diagnosis of enlarged cervical lymph nodes includes the following: bacterial, mycobacterial and viral infections, granulomatous conditions such as sarcoidosis, primary and secondary involvement in lymphoma; other metastatic neoplasms such as from breast and lung, as well as more uncommon conditions such as sinus histiocytosis, eosinophilic granuloma, Kimura's disease, and Kikuchi's disease. This article will review the anatomy and regional classification of the cervical lymph node chains and discuss the common and uncommon etiologies of cervical lymph node enlargement.