[Diagnostic strategy in front of adenopathy]

ABSTRACT

Adenopathy recognition is not a problem of clinical diagnosis. But the aetiologic workup is more difficult. Patient's antecedents, lymph node characteristics, associated functional and physical symptoms are cap ital elements for diagnostic orientation. Aetiology can be apparent from the start acute suppuration of lymph node; infectious mononucleosis; primary syphilis... But sometimes, adenopathy is isolated. In this case, a minimal and cheap work-up is recommended blood count; erythrocyte sedimentation rate; tuberculin intradermal test; and chest radiograph. This first step is aimed to diagnose either a highly frequent aetiology [tuberculosis, pyogenic infection] or a severe disease whose diagnosis is easy to do [leukaemia]. If it's negative, direct exploration by needle puncture or biopsy of the adenopathy is indicated. These investigations will uncover either benign aetiology, infectious, immunological, or malignant cause, such lymphoma, leukaemia or epithelioma