{"id":4102,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/lymphadenopathy\/"},"modified":"2025-07-15T09:33:14","modified_gmt":"2025-07-15T08:33:14","slug":"lymphadenopathy","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/haematology\/lymphadenopathy\/","title":{"rendered":"Lymphadenopathy"},"content":{"rendered":"\n<p><strong>Definition:<\/strong> Lymphadenopathy refers to persistent enlarged lymph glands.<\/p>\n\n\n\n<p>Common causes of enlarged lymph glands include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>acute bacterial infections and viral infections such as EBV and HIV<\/li>\n\n\n\n<li>chronic infections such as TB or toxoplasma<\/li>\n\n\n\n<li>immunological disorders including rheumatoid arthritis, systemic lupus and sarcoidosis<\/li>\n\n\n\n<li>chronic skin conditions such as chronic eczema<\/li>\n\n\n\n<li>drug reactions especially carbamazepine and some anti-psychotic medication<\/li>\n\n\n\n<li>haematological malignancies such as lymphoma or metastatic carcinoma.<\/li>\n<\/ul>\n\n\n\n<p class=\"has-alert-red-color has-text-color has-link-color wp-elements-2a580bda5ac86a56151ff5cb4838d5d9\"><strong>Isolated Lymphadenopathy following COVID-19 vaccination.<\/strong>&nbsp;<\/p>\n\n\n\n<p>If a patient presents with lymphadenopathy localised to&nbsp;a recent COVID-19 vaccination site, please consider asking the patient to self-monitor and report back once they are 4 weeks post-vaccination if it persists.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>C.M &amp; L.W 15-07-25<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Size significant lymphadenopathy, persistent for 6 weeks or more:<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Nodes at an unusual site<\/li>\n\n\n\n<li>Lymph nodes that are increasing in size<\/li>\n\n\n\n<li>Nodes &gt; 2cms<\/li>\n\n\n\n<li>Widespread nodal enlargement and \/ or splenomegaly.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Size significant lymphadenopathy with significant systemic symptoms : drenching night sweats, weight loss, fever, alcohol-induced pain.<\/li>\n<\/ul>\n\n\n\n<p>Prior to referral, please undertake the investigations listed under Primary Care Management.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<p><strong>\u2018Pea-sized\u2019 nodes, 1cm or less in diameter<\/strong>, in individuals with no significant systemic symptoms. This is a common clinical finding especially in slim young adults and in most cases is not abnormal.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p>Please refer via SCI Gateway to haematology at the WGH or St Johns.<\/p>\n\n\n\n<p>Patients with clinically significant<em> isolated<\/em> neck nodes should be referred directly to <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/ENTADULT\/NeckLump\" target=\"_blank\" rel=\"noreferrer noopener\">ENT neck lump clinic<\/a> for consideration of biopsy (<strong><em>no need to dual refer to haematology).<\/em><\/strong><\/p>\n\n\n\n<p>Patients with clinically significant <em>isolated<\/em> axillary nodes should be referred directly to the <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/BreastDisease\/BreastLump\" target=\"_blank\" rel=\"noreferrer noopener\">Breast Clinic<\/a> for further management (<strong><em>no need to dual refer to haematology).<\/em><\/strong><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h3 class=\"wp-block-heading\">Primary care investigations<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>FBC, ESR<\/li>\n\n\n\n<li>Blood film<\/li>\n\n\n\n<li>Viral serology for EBV (IgM), CMV, HIV<\/li>\n\n\n\n<li>Serology for Toxoplasma<\/li>\n\n\n\n<li><a rel=\"noreferrer noopener\" href=\"https:\/\/apps.nhslothian.scot\/refhelp\/immunology\/immunoglobulin-testing\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/immunology\/immunoglobulin-testing\" target=\"_blank\">Quantitative immunoglobulins + serum electrophoresis<\/a><\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><a href=\"https:\/\/cks.nice.org.uk\/topics\/neck-lump\/management\/lymphadenopathy\/#:~:text=Management%20of%20lymphadenopathy%20If%20there%20is%20suspected%20upper,there%20is%20a%20suspected%20infective%20cause%20for%20lymphadenopathy%3A\">NICE guidance on lymphadenopathy<\/a><\/p>\n\n\n<\/div><\/div>\n<\/div>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Definition: Lymphadenopathy refers to persistent enlarged lymph glands. Common causes of enlarged lymph glands include: Isolated Lymphadenopathy following COVID-19 vaccination.&nbsp; If a patient presents with lymphadenopathy localised to&nbsp;a recent COVID-19 vaccination site, please consider asking the patient to self-monitor and report back once they are 4 weeks post-vaccination if it persists.&nbsp;&nbsp; C.M &amp; L.W 15-07-25<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3981,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[262],"class_list":["post-4102","page","type-page","status-publish","hentry","category-lymphadenopathy"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/haematology\/lymphadenopathy\/\" rel=\"tag\">Lymphadenopathy<\/a>","rttpg_excerpt":"Definition: Lymphadenopathy refers to persistent enlarged lymph glands. Common causes of enlarged lymph glands include: Isolated Lymphadenopathy following COVID-19 vaccination.&nbsp; If a patient presents with lymphadenopathy localised to&nbsp;a recent COVID-19 vaccination site, please consider asking the patient to self-monitor and report back once they are 4 weeks post-vaccination if it persists.&nbsp;&nbsp; C.M &amp; L.W 15-07-25","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4102","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4102"}],"version-history":[{"count":21,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4102\/revisions"}],"predecessor-version":[{"id":24651,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4102\/revisions\/24651"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3981"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4102"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4102"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}