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Reactive Lymph Nodes
Surjith Vattoth, MD, FRCR; Nicholas A. Koontz, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Reactive adenopathy, reactive lymphoid hyperplasia, nodal hyperplasia
              • Definitions

                • "Reactive" implies benign etiology
                • Benign, reversible enlargement of nodes in response to antigen stimulus
                • Lymphadenopathy: Enlargement of lymph nodes
                  • Due to proliferation of normal lymphatic tissue or invasion by inflammatory/neoplastic cells
                • Lymphadenitis: Lymphadenopathy due to invasion by inflammatory cells

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Pattanayak S et al: Ultrasound evaluation of cervical lymphadenopathy: can it reduce the need of histopathology/cytopathology? Med J Armed Forces India. 74(3):227-34, 2018
                                              2. Zakaria OM et al: Reliability of sonoelastography in predicting pediatric cervical lymph node malignancy. Pediatr Surg Int. 34(8):885-90, 2018
                                              3. El Beltagi AH et al: Imaging of pediatric chronic neck infections. J Pediatr Neurol. 15:294-304, 2017
                                              4. Al Kadah B et al: Cervical lymphadenopathy: study of 251 patients. Eur Arch Otorhinolaryngol. 272(3):745-52, 2015
                                              5. Choi YJ et al: Ultrasound elastography for evaluation of cervical lymph nodes. Ultrasonography. 34(3):157-64, 2015
                                              6. Eisenmenger LB et al: Imaging of head and neck lymph nodes. Radiol Clin North Am. 53(1):115-32, 2015
                                              7. Si J et al: Usefulness of 3T diffusion-weighted MRI for discrimination of reactive and metastatic cervical lymph nodes in patients with oral squamous cell carcinoma: a pilot study. Dentomaxillofac Radiol. 43(3):20130202, 2014
                                              8. Srinivasan A et al: Biologic imaging of head and neck cancer: the present and the future. AJNR Am J Neuroradiol. 33(4):586-94, 2012
                                              9. Thoeny HC et al: Diffusion-weighted MR imaging in the head and neck. Radiology. 263(1):19-32, 2012
                                              10. Annam V et al: Clinicopathologic profile of significant cervical lymphadenopathy in children aged 1-12 years. Acta Cytol. 53(2):174-8, 2009
                                              11. Holzapfel K et al: Value of diffusion-weighted MR imaging in the differentiation between benign and malignant cervical lymph nodes. Eur J Radiol. 72(3):381-7, 2009
                                              12. Abdel-Galiil K et al: Incidence of sarcoidosis in head and neck cancer. Br J Oral Maxillofac Surg. 46(1):59-60, 2008
                                              13. Chan JM et al: Ultrasonography of abnormal neck lymph nodes. Ultrasound Q. 23(1):47-54, 2007
                                              14. Leung AK et al: Childhood cervical lymphadenopathy. J Pediatr Health Care. 18(1):3-7, 2004
                                              15. Ishikawa M et al: MR imaging of lymph nodes in the head and neck. Magn Reson Imaging Clin N Am. 10(3):527-42, 2002
                                              16. Ahuja AT et al: Distribution of intranodal vessels in differentiating benign from metastatic neck nodes. Clin Radiol. 56(3):197-201, 2001
                                              17. Papakonstantinou O et al: High-resolution and color Doppler ultrasonography of cervical lymphadenopathy in children. Acta Radiol. 42(5):470-6, 2001
                                              18. Ahuja A et al: Grey-scale sonography in assessment of cervical lymphadenopathy: review of sonographic appearances and features that may help a beginner. Br J Oral Maxillofac Surg. 38(5):451-9, 2000
                                              19. Hudgins PA: Nodal and nonnodal inflammatory processes of the pediatric neck. Neuroimaging Clin N Am. 10(1):181-92, ix, 2000
                                              20. Robson CD et al: Nontuberculous mycobacterial infection of the head and neck in immunocompetent children: CT and MR findings. AJNR Am J Neuroradiol. 20(10):1829-35, 1999
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Synonyms

                                                            • Reactive adenopathy, reactive lymphoid hyperplasia, nodal hyperplasia
                                                          • Definitions

                                                            • "Reactive" implies benign etiology
                                                            • Benign, reversible enlargement of nodes in response to antigen stimulus
                                                            • Lymphadenopathy: Enlargement of lymph nodes
                                                              • Due to proliferation of normal lymphatic tissue or invasion by inflammatory/neoplastic cells
                                                            • Lymphadenitis: Lymphadenopathy due to invasion by inflammatory cells

                                                          IMAGING

                                                          • General Features

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Nuclear Medicine Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Pattanayak S et al: Ultrasound evaluation of cervical lymphadenopathy: can it reduce the need of histopathology/cytopathology? Med J Armed Forces India. 74(3):227-34, 2018
                                                                                          2. Zakaria OM et al: Reliability of sonoelastography in predicting pediatric cervical lymph node malignancy. Pediatr Surg Int. 34(8):885-90, 2018
                                                                                          3. El Beltagi AH et al: Imaging of pediatric chronic neck infections. J Pediatr Neurol. 15:294-304, 2017
                                                                                          4. Al Kadah B et al: Cervical lymphadenopathy: study of 251 patients. Eur Arch Otorhinolaryngol. 272(3):745-52, 2015
                                                                                          5. Choi YJ et al: Ultrasound elastography for evaluation of cervical lymph nodes. Ultrasonography. 34(3):157-64, 2015
                                                                                          6. Eisenmenger LB et al: Imaging of head and neck lymph nodes. Radiol Clin North Am. 53(1):115-32, 2015
                                                                                          7. Si J et al: Usefulness of 3T diffusion-weighted MRI for discrimination of reactive and metastatic cervical lymph nodes in patients with oral squamous cell carcinoma: a pilot study. Dentomaxillofac Radiol. 43(3):20130202, 2014
                                                                                          8. Srinivasan A et al: Biologic imaging of head and neck cancer: the present and the future. AJNR Am J Neuroradiol. 33(4):586-94, 2012
                                                                                          9. Thoeny HC et al: Diffusion-weighted MR imaging in the head and neck. Radiology. 263(1):19-32, 2012
                                                                                          10. Annam V et al: Clinicopathologic profile of significant cervical lymphadenopathy in children aged 1-12 years. Acta Cytol. 53(2):174-8, 2009
                                                                                          11. Holzapfel K et al: Value of diffusion-weighted MR imaging in the differentiation between benign and malignant cervical lymph nodes. Eur J Radiol. 72(3):381-7, 2009
                                                                                          12. Abdel-Galiil K et al: Incidence of sarcoidosis in head and neck cancer. Br J Oral Maxillofac Surg. 46(1):59-60, 2008
                                                                                          13. Chan JM et al: Ultrasonography of abnormal neck lymph nodes. Ultrasound Q. 23(1):47-54, 2007
                                                                                          14. Leung AK et al: Childhood cervical lymphadenopathy. J Pediatr Health Care. 18(1):3-7, 2004
                                                                                          15. Ishikawa M et al: MR imaging of lymph nodes in the head and neck. Magn Reson Imaging Clin N Am. 10(3):527-42, 2002
                                                                                          16. Ahuja AT et al: Distribution of intranodal vessels in differentiating benign from metastatic neck nodes. Clin Radiol. 56(3):197-201, 2001
                                                                                          17. Papakonstantinou O et al: High-resolution and color Doppler ultrasonography of cervical lymphadenopathy in children. Acta Radiol. 42(5):470-6, 2001
                                                                                          18. Ahuja A et al: Grey-scale sonography in assessment of cervical lymphadenopathy: review of sonographic appearances and features that may help a beginner. Br J Oral Maxillofac Surg. 38(5):451-9, 2000
                                                                                          19. Hudgins PA: Nodal and nonnodal inflammatory processes of the pediatric neck. Neuroimaging Clin N Am. 10(1):181-92, ix, 2000
                                                                                          20. Robson CD et al: Nontuberculous mycobacterial infection of the head and neck in immunocompetent children: CT and MR findings. AJNR Am J Neuroradiol. 20(10):1829-35, 1999