Diagnostic approach to lymph node enlargement

Divisione di Medicina Interna e Oncologia Medica, Dipartimento di Medicina Interna, Universita di Pavia, IRCCS Policlinico S. Matteo, Pavia, Italy. BACKGROUND AND OBJECTIVE: How to reach the correct diagnosis of a lymph node enlargement is still a problem which strongly challenges the knowledge and experience of the clinician. Organized and specifically oriented literature on the right sequential steps and the logical criteria that should guide this diagnostic approach is still lacking. METHODS: The authors have tried to exploit available knowledge and their personal experience by correlating a large body of information regarding size, physical characteristics, anatomical location of enlarged lymph nodes, and the possible epidemiological, environmental, occupational and clinical categorization of this condition. RESULTS AND CONCLUSIONS: It was intended that such material would have constituted the basis of a hypothetic decision-making tree, but this was impossible because of the lack of epidemiological investigation and registry data. Nevertheless, we present this preparatory work here in order to stimulate the interest of concerned readers and because of its possible direct usefulness in hematologic practice.