1. CERVICAL LYMPHADENOPATHY
Dept of Oral Medicine & Radiology
Yenepoya Dental College
Mangalore

2. Lymphnodes are encapsulated centres of lymphocyte differetiation and proliferation

3. Small, oval or reniform bodies
About 0.1 – 2.5 cm long
Numerous in neck, mediastinum, post
abdominal wall & pelvis
about LN
Head and neck – 70 LN

5. FUNCTIONS Generate mature and prime B and T cells
Add antibodies to circulation
Filter particles, microbes from lymph

6. Submental
Submandibular
Parotid
Upper cervical
Middle cervical
Lower cervical
Supraclavicular fossa
Posterior triangle (accessory chain)

7. Lymphadenitis - an inflammation
or infection of lymph node and
frequently occurs when an infection
is present in the tissues drained by
particular node pathway

10. CAUSES I . INFECTION BACTERIAL / VIRAL / PARASITIC II. NEOPLASIA
PRIMARY
SECONDARY- Ca / Mal Malanoma
III. MISCELANIOUS
SARCOIDOSIS / DRUG REACTION/C T DISEASES

11. Infectious Causes Non-infectious causes Adenovirus Hodgkin's disease
CMV
Enterovirus
EBV
Herpes simplex
Staphlococcus infection
Cat Scratch Diseas
Hodgkin's disease
Lymphomas
Leukemia
Metastatic disease
Histiocytosis
SLE
Kawasaki Disease

13. LYMPH NODES a. SITE , b. SIZE , c. NUMBER , d. TENDERNESS
e.CONSISTANCY,
f.. FIXITY,

15. INVESTIGATION HISTORY CLINICAL EXAMINATION SPECIAL INVESTIGATION
TEMP/ DRAINAGE/ DENTAL & MUCOSAL /ENT
SPECIAL INVESTIGATION
BLOOD PICTURE
CHEST X RAY
SEROLOGY
KVIEM TEST
MANTOUX TEST
FNAC / FNAB
BIOPSY

16. F N A C

17. Two distinct types of benign LN enlargement
Non tender
Tender / painful

18. NON TENDER LYMPHOID HYPERPLASIA
Persistent chronic lymphadenitis or
A permanenly enlarged LN after
acute or chronic lymphadenitis
LN are solitary, discrete, asymtomatic and freely
movable
Submandibular ,submental and subdigastric LN

19. Secondary carcinoma – hard & fixed
D/D
Secondary carcinoma – hard & fixed
Management
Patient recalled after 2 week & evaluated
If doubtful – removal of node & examination

20. ACUTE LYMPHADENITIS: Most common pathologic cervical enlargement
Primary infection in oral cavity,
nasal cavity , tonsils or Pharynx
Cause painful , swollen nodes in
submental, submandibular /
subdigastric
Rapid regression of inflammation
- nodes Normal & non- palpable

21. D/D SEVERAL NODES MAY BE INVOLVED MOVABLE OR FIXED LUDWIG’S ANGINA
INFECTED CYST

22. MANAGEMENT
When primary infection eliminated
Lymphadenitis regress
Adequate doses of antibiotics

23. LN are frequent sites METASTATIC CARCINOMA TO CERVICAL NODES
Result of metastatic spread from
primary tumors of head & neck
Squmous cell carcinoma is most
common tumor spreading to
cervical LN
Adenocarcinoma of salivary glands,
Scc of skin & melonoma metastasize

24. Lymphatic trunks drain upper extremities & rest of body
below clavicles, so solitary metastatic nodes can be from
primary tumors of breast, lungs & stomach
FEATURES
Usually painless
Detected on clinical examination
Feel stony hard & freely movable till they penetrate node
capsule & Invade surrounding tissues
Submandibular & subdigastric nodes most frequent sites

25. D/D
Fibrosed nodes or nodes undergone non tender
lymphoid hyperplasia
Lymphoma (rubbery)
MANAGEMENT
Combination of resection, radiation & chemotherapy
Prognosis is guarded

26. A neoplastic proliferation within the reticuloendothelial system that
occurs as primry tumor of lymph node
LYMPHOMA

27. FEATURES
Solitary / multiple
Unilateral / bilateral
Usually rubbery
Advanced cases – patient is ill with fever,
TC & DLC may be markedly changed
Other node groups axillae, groin &
mediastinum involved

28. D/D
Multiple & disseminated nodal involvement
occur in certain viral diseases & in mononucleosis
Nodes are tender & painful
MANAGEMENT
Radiation & chemotoxic drugs