Generally, lymph nodes less than 3 mm are considered normal

Abnormal lymph nodes are as below

  • Epitrochlear lymph nodes > 5mm

  • Cervical lymph nodes >10 mm

  • Inguinal lymph nodes > 15 mm



  • a) Generalised lymphadenopathy-

When 2 or more groups of lymph node regions are enlarged

Liver and spleen may also be enlarged.

  • b) Local lymphadenopathy



a) Systemic infections

  • Bacterial infections

  • Viral infections- EBV/ EMV/ Hepatitis/

  • Tuberculosis/ syphilis/ Toxoplasma

  • Brucella/ typhoid/ malaria

  • Chronic granulomatous disease/ HIV

b) Immune-mediated conditions

  • SLE/ Rheumatoid arthritis

  • Kawasaki disease/ Hyper IgD syndrome

c) Storage diseases-

  • Gaucher/ Niemann Pick disease

d) Malignancy-

  • Leukemia/ Lymphoma

  • Neuroblastoma/ Histiocytosis

e) Metabolic causes-

  • Hyperthyroidism/ adrenal insufficiency

  • Sarcoidosis/ Histiocytosis



  • Viral Upper respiratory tract infection( EBV/CMV virus)

  • Bacterial infection (Staphylococcal/ Streptococcal)

  • Atypical mycobacterial adenitis

  • Toxoplasmosis

  • Kawasaki disease

  • Hyper IgD or IgE syndrome

  • Histiocytosis

  • Sarcoidosis


HISTORY to consider-

  • History of fever- Suggesting systemic infections

  • History of rash- Suggesting EBV/ CMV/ Chronic granulomatous disease/ syphilis

  • History of travel- look for Malaria/ Histoplasmosis

  • History of animal exposure- suggesting Brucellosis/ cat scratch disease/ tularemia

  • History of blood transfusion – Hepatitis A/B/C, CMV virus/ HIV

  • History of Malar rash, alopecia/ cardiac disease/ Raynaud’s phenomenon – Systemic lupus erythematosus

  • History of fever/ rash/ joint disease- Juvenile rheumatoid arthritis

  • History of fever/ rash/ conjunctivitis/ skin peeling- Kawasaki disease

  • History of hepatosplenomegaly/ growth failure/ delay in development- Storage diseases

  • History of weight loss/ night sweats/ bone pain/ bleeds- Malignancy




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