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Reactive Lymph Nodes
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

                • Benign, reversible enlargement of nodes in response to antigen stimulus
                  • May be acute or chronic, localized or generalized
                • "Reactive" implies benign etiology

              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. Becker AS et al: Multidisciplinary recommendations regarding post-vaccine adenopathy and radiologic imaging: radiology scientific expert panel. Radiology. 210436, 2021
                                              2. Mitchell OR et al: Supraclavicular lymphadenopathy following COVID-19 vaccination: an increasing presentation to the two-week wait neck lump clinic? Br J Oral Maxillofac Surg. 59(3):384-85, 2021
                                              3. Hashmi AA et al: Utility of fine needle aspiration cytology in the evaluation of lymphadenopathy. Cureus. 12(12):e11990, 2020
                                              4. Park JE et al: Cervical lymphadenopathy in children: a diagnostic tree analysis model based on ultrasonographic and clinical findings. Eur Radiol. 30(8):4475-85, 2020
                                              5. Kuno H et al: CT texture analysis of cervical lymph nodes on contrast-enhanced [18F] FDG-PET/CT images to differentiate nodal metastases from reactive lymphadenopathy in HIV-positive patients with head and neck squamous cell carcinoma. AJNR Am J Neuroradiol. 40(3):543-50, 2019
                                              6. Vali R et al: FDG uptake in cervical lymph nodes in children without head and neck cancer. Pediatr Radiol. 47(7):860-7, 2017
                                              7. Al Kadah B et al: Cervical lymphadenopathy: study of 251 patients. Eur Arch Otorhinolaryngol. 272(3):745-52, 2015
                                              8. Choi YJ et al: Ultrasound elastography for evaluation of cervical lymph nodes. Ultrasonography. 34(3):157-64, 2015
                                              9. Eisenmenger LB et al: Imaging of head and neck lymph nodes. Radiol Clin North Am. 53(1):115-32, 2015
                                              10. 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
                                              11. 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
                                              12. Thoeny HC et al: Diffusion-weighted MR imaging in the head and neck. Radiology. 263(1):19-32, 2012
                                              13. Annam V et al: Clinicopathologic profile of significant cervical lymphadenopathy in children aged 1-12 years. Acta Cytol. 53(2):174-8, 2009
                                              14. 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, 2008
                                              15. Chan JM et al: Ultrasonography of abnormal neck lymph nodes. Ultrasound Q. 23(1):47-54, 2007
                                              16. Leung AK et al: Childhood cervical lymphadenopathy. J Pediatr Health Care. 18(1):3-7, 2004
                                              17. 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
                                              18. Ahuja AT et al: Distribution of intranodal vessels in differentiating benign from metastatic neck nodes. Clin Radiol. 56(3):197-201, 2001
                                              19. Papakonstantinou O et al: High-resolution and color Doppler ultrasonography of cervical lymphadenopathy in children. Acta Radiol. 42(5):470-6, 2001
                                              20. 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
                                              21. Hudgins PA: Nodal and nonnodal inflammatory processes of the pediatric neck. Neuroimaging Clin N Am. 10(1):181-92, ix, 2000
                                              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

                                                            • Benign, reversible enlargement of nodes in response to antigen stimulus
                                                              • May be acute or chronic, localized or generalized
                                                            • "Reactive" implies benign etiology

                                                          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. Becker AS et al: Multidisciplinary recommendations regarding post-vaccine adenopathy and radiologic imaging: radiology scientific expert panel. Radiology. 210436, 2021
                                                                                          2. Mitchell OR et al: Supraclavicular lymphadenopathy following COVID-19 vaccination: an increasing presentation to the two-week wait neck lump clinic? Br J Oral Maxillofac Surg. 59(3):384-85, 2021
                                                                                          3. Hashmi AA et al: Utility of fine needle aspiration cytology in the evaluation of lymphadenopathy. Cureus. 12(12):e11990, 2020
                                                                                          4. Park JE et al: Cervical lymphadenopathy in children: a diagnostic tree analysis model based on ultrasonographic and clinical findings. Eur Radiol. 30(8):4475-85, 2020
                                                                                          5. Kuno H et al: CT texture analysis of cervical lymph nodes on contrast-enhanced [18F] FDG-PET/CT images to differentiate nodal metastases from reactive lymphadenopathy in HIV-positive patients with head and neck squamous cell carcinoma. AJNR Am J Neuroradiol. 40(3):543-50, 2019
                                                                                          6. Vali R et al: FDG uptake in cervical lymph nodes in children without head and neck cancer. Pediatr Radiol. 47(7):860-7, 2017
                                                                                          7. Al Kadah B et al: Cervical lymphadenopathy: study of 251 patients. Eur Arch Otorhinolaryngol. 272(3):745-52, 2015
                                                                                          8. Choi YJ et al: Ultrasound elastography for evaluation of cervical lymph nodes. Ultrasonography. 34(3):157-64, 2015
                                                                                          9. Eisenmenger LB et al: Imaging of head and neck lymph nodes. Radiol Clin North Am. 53(1):115-32, 2015
                                                                                          10. 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
                                                                                          11. 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
                                                                                          12. Thoeny HC et al: Diffusion-weighted MR imaging in the head and neck. Radiology. 263(1):19-32, 2012
                                                                                          13. Annam V et al: Clinicopathologic profile of significant cervical lymphadenopathy in children aged 1-12 years. Acta Cytol. 53(2):174-8, 2009
                                                                                          14. 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, 2008
                                                                                          15. Chan JM et al: Ultrasonography of abnormal neck lymph nodes. Ultrasound Q. 23(1):47-54, 2007
                                                                                          16. Leung AK et al: Childhood cervical lymphadenopathy. J Pediatr Health Care. 18(1):3-7, 2004
                                                                                          17. 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
                                                                                          18. Ahuja AT et al: Distribution of intranodal vessels in differentiating benign from metastatic neck nodes. Clin Radiol. 56(3):197-201, 2001
                                                                                          19. Papakonstantinou O et al: High-resolution and color Doppler ultrasonography of cervical lymphadenopathy in children. Acta Radiol. 42(5):470-6, 2001
                                                                                          20. 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
                                                                                          21. Hudgins PA: Nodal and nonnodal inflammatory processes of the pediatric neck. Neuroimaging Clin N Am. 10(1):181-92, ix, 2000