lymphadenopathy syndrome

リンパ節腫大症候群

関

AIDS-related complex、arc

WordNet

1. a continuous portion of a circle
2. a pattern of symptoms indicative of some disease
3. a complex of concurrent things; "every word has a syndrome of meanings"
4. chronic abnormal enlargement of the lymph nodes (usually associated with disease)

PrepTutorEJDIC

1. 『弧』,円弧 / 電弧(2点間を弧状に流れる電流) / 弧を描く / 電弧を生じる
2. (疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/12/20 10:32:17」(JST)

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Lymphadenopathy
Neck lymphadenopathy associated with infectious mononucleosis
Classification and external resources
Specialty	Infectious disease
ICD-10	I88, L04, R59.1
ICD-9-CM	289.1-289.3, 683, 785.6
DiseasesDB	22225
MedlinePlus	001301
eMedicine	ped/1333
MeSH	D008206

Lymphadenopathy or adenopathy is disease of the lymph nodes, in which they are abnormal in size, number, or consistency. Lymphadenopathy of an inflammatory type (the most common type) is lymphadenitis, producing swollen or enlarged lymph nodes. In clinical practice, the distinction between lymphadenopathy and lymphadenitis is rarely made and the words are usually treated as synonymous. Inflammation of the lymphatic vessels is known as lymphangitis. Infectious lymphadenitides affecting lymph nodes in the neck are often called scrofula.

The term comes from the word lymph and a combination of the Greek words αδένας, adenas ("gland") and παθεία, patheia ("act of suffering" or "disease").

Lymphadenopathy is a common and nonspecific sign. Common causes include infections (from minor ones such as the common cold to dangerous ones such as HIV/AIDS), autoimmune diseases, and cancers. Lymphadenopathy is also frequently idiopathic and self-limiting.

Types

Micrograph of dermatopathic lymphadenopathy, a type of lymphadenopathy. H&E stain.

• By extent:
  • Localized lymphadenopathy: due to localized spot of infection e.g., an infected spot on the scalp will cause lymph nodes in the neck on that same side to swell up
  • Generalized lymphadenopathy: due to a systemic infection of the body e.g., influenza or secondary syphilis
    • Persistent generalized lymphadenopathy (PGL): persisting for a long time, possibly without an apparent cause
• By malignancy: Benign lymphadenopathy is distinguished from malignant causes which mainly refer to lymphomas or lymph node metastasis
• By localization, including hilar lymphadenopathy.
• Dermatopathic lymphadenopathy: lymphadenopathy associated with skin disease.

Causes

Retroperitoneal lymphadenopathies of testicular seminoma, embrace the aorta. Computed tomography image.

Lymph node enlargement is recognized as a common sign of infectious, autoimmune, or malignant disease. Examples may include:

• Reactive: acute infection (e.g., bacterial, or viral), or chronic infections (tuberculous lymphadenitis, cat-scratch disease).
  • The most distinctive sign of bubonic plague is extreme swelling of one or more lymph nodes that bulge out of the skin as "buboes." The buboes often become necrotic and may even rupture.
  • Infectious mononucleosis is an acute viral infection caused by Epstein-Barr virus and may be characterized by a marked enlargement of the cervical lymph nodes.
  • It is also a sign of cutaneous anthrax and Human African trypanosomiasis
  • Toxoplasmosis, a parasitic disease, gives a generalized lymphadenopathy (Piringer-Kuchinka lymphadenopathy).
  • Plasma cell variant of Castleman's disease - associated with HHV-8 infection and HIV infection
  • Mesenteric lymphadenitis after viral systemic infection (particularly in the GALT in the appendix) can commonly present like appendicitis.

Less common infectious causes of lymphadenopathy may include bacterial infections such as cat scratch disease, tularemia, brucellosis, or prevotella.

• Tumoral:
  • Primary: Hodgkin lymphoma and non-Hodgkin lymphoma give lymphadenopathy in all or a few lymph nodes.
  • Secondary: metastasis, Virchow's Node, neuroblastoma, and chronic lymphocytic leukemia.
• Autoimmune etiology: systemic lupus erythematosus and rheumatoid arthritis may have a generalized lymphadenopathy.
• Immunocompromised etiology: AIDS. Generalized lymphadenopathy is an early sign of infection with human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS). "Lymphadenopathy syndrome" has been used to describe the first symptomatic stage of HIV progression, preceding a diagnosis of AIDS.
• Bites from certain venomous snakes such as the pit viper
• Unknown etiology: Kikuchi disease, progressive transformation of germinal centers, sarcoidosis, hyaline-vascular variant of Castleman's disease, Rosai-Dorfman disease, Kawasaki disease, Kimura disease

Benign (reactive) lymphadenopathy

Benign lymphadenopathy is a common biopsy finding, and may often be confused with malignant lymphoma. It may be separated into major morphologic patterns, each with its own differential diagnosis with certain types of lymphoma. Most cases of reactive follicular hyperplasia are easy to diagnose, but some cases may be confused with follicular lymphoma. There are six distinct patterns of benign lymphadenopathy:

• Follicular hyperplasia: This is the most common type of reactive lymphadenopathy.
• Paracortical hyperplasia/Interfollicular hyperplasia: It is seen in viral infections, skin diseases, and nonspecific reactions.
• Sinus histiocytosis: It is seen in lymph nodes draining limbs, inflammatory lesions, and malignancies.
• Nodal extensive necrosis
• Nodal granulomatous inflammation
• Nodal extensive fibrosis (Connective tissue framework)
• Nodal deposition of interstitial substance

These morphological patterns are never pure. Thus, reactive follicular hyperplasia can have a component of paracortical hyperplasia. However, this distinction is important for the differential diagnosis of the cause.

Localization

• Mediastinal lymphadenopathy
• Bilateral hilar lymphadenopathy

See also

• Adenitis
• Lymphovascular invasion

References

External links

• HPC:13820 on humpath.com (Digital slides)

UpToDate Contents

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• 1. 小児における末梢のリンパ節腫脹：評価および診断的アプローチ peripheral lymphadenopathy in children evaluation and diagnostic approach
• 2. 小児における末梢のリンパ節腫脹 peripheral lymphadenopathy in children etiology
• 3. 成人における末梢リンパ節腫大の評価 evaluation of peripheral lymphadenopathy in adults
• 4. 小児における頸部リンパ節炎：診断的アプローチおよび初期マネージメント cervical lymphadenitis in children diagnostic approach and initial management
• 5. Sézary症候群の臨床症状、病理学的特徴、および診断 clinical presentation pathologic features and diagnosis of sezary syndrome

English Journal

• Deletion of the antiphospholipid syndrome autoantigen β2 GPI potentiates the lupus autoimmune phenotype in a toll-like receptor 7 mediated murine model.

• Giannakopoulos B1, Mirarabshahi P, Miao Q, Weatherall C, Qi JC, Tanaka K, Millar E, Vonthethoff L, Gatto D, Spielman D, Krilis SA.Author information 1Department of Infectious Diseases, Immunology and Sexual Health, St George Hospital, Kogarah, NSW, 2217, Australia; Department of Medicine, St George Clinical School, University of NSW, Kogarah, NSW, 2217, Australia; Department of Rheumatology, St George Hospital, Kogarah, NSW, 2217, Australia.AbstractObjective: The BXSByaa murine strain is a model of systemic lupus erythematosus dependent on Toll-like receptor 7 gene duplication. The objective of this study was to systematically describe the amplified autoimmune phenotype that was noted when the gene for the soluble plasma protein β2 GPI was deleted in BXSByaa male mice. Methods: We generated BXSByaa and NZW strains that had the β2 GPI gene knocked out by backcrossing the wild type strains with C57BL/6 β2 GPI(-/-) mice for 10 generations. Sex and age matched mice of the various strains were housed in identical conditions and sacrificed at fixed time intervals. Serum and tissue were collected at various time points. Lupus associated autoantibodies, inflammatory cytokines, and the type I interferon (IFN-1) genetic signature were measured. Flow cytometric analyses of lymphocyte populations were undertaken. The severity of glomerulonephritis was graded by two independent renal histopathologists. Results: BXSByaaβ2 GPI(-/-) male mice developed significant lymphadenopathy and splenomegaly compared to age matched controls. The BXSByaaβ2 GPI(-/-) male mice had significantly higher levels of autoantibodies, an increase in inflammatory cytokines including TNF-α, IL-6 and BAFF and more severe glomerulonephritis. The IFN-1 gene signature in BXSByaaβ2 GPI(-/-) male mice was significantly elevated compared to controls. The BXSByaaβ2 GPI(-/-) male mice also had marked dysregulation of various B and T cell populations in the spleens and lymph nodes, and disturbance in apoptotic cell clearance. Conclusion: Deletion of β2 GPI accelerates and potentiates the autoimmune phenotype in BXSByaa male mice. © 2014 American College of Rheumatology.
• Arthritis & rheumatology (Hoboken, N.J.).Arthritis Rheumatol.2014 Apr 1. doi: 10.1002/art.38646. [Epub ahead of print]
• Objective: The BXSByaa murine strain is a model of systemic lupus erythematosus dependent on Toll-like receptor 7 gene duplication. The objective of this study was to systematically describe the amplified autoimmune phenotype that was noted when the gene for the soluble plasma protein β2 GPI was de
• PMID 24692206

• Tuberculosis Immune Reconstitution Inflammatory Syndrome in A5221 STRIDE: Timing, Severity, and Implications for HIV-TB Programs.

• Luetkemeyer AF1, Kendall MA, Nyirenda M, Wu X, Ive P, Benson CA, Andersen JW, Swindells S, Sanne IM, Havlir DV, Kumwenda J; Adult AIDS Clinical Trials Group A5221 Study Team.Author information 1*HIV/AIDS Division, San Francisco General Hospital, University of California, San Francisco, CA; †Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, MA; ‡Department of Medicine, College of Medicine, Blantyre, Malawi; §Faculty of Heath Sciences, University of the Witwatersrand, Johannesburg, South Africa; ‖Division of Infectious Diseases, School of Medicine, University of California, San Diego, CA; and ¶Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE.AbstractRATIONALE AND OBJECTIVES: Earlier initiation of antiretroviral therapy (ART) in HIV-tuberculosis (TB) is associated with increased immune reconstitution inflammatory syndrome (IRIS). The severity, frequency, and complications of TB IRIS were evaluated in A5221, a randomized trial of earlier ART (within 2 weeks after TB treatment initiation) vs. later ART (8-12 weeks after TB treatment) in HIV-infected patients starting TB treatment.
• Journal of acquired immune deficiency syndromes (1999).J Acquir Immune Defic Syndr.2014 Apr 1;65(4):423-8. doi: 10.1097/QAI.0000000000000030.
• RATIONALE AND OBJECTIVES: Earlier initiation of antiretroviral therapy (ART) in HIV-tuberculosis (TB) is associated with increased immune reconstitution inflammatory syndrome (IRIS). The severity, frequency, and complications of TB IRIS were evaluated in A5221, a randomized trial of earlier ART (wit
• PMID 24226057

• Mutations in PIK3CD Can Cause Hyper IgM Syndrome (HIGM) Associated with Increased Cancer Susceptibility.

• Crank MC1, Grossman JK, Moir S, Pittaluga S, Buckner CM, Kardava L, Agharahimi A, Meuwissen H, Stoddard J, Niemela J, Kuehn H, Rosenzweig SD.Author information 1Laboratory of Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.AbstractAutosomal dominant gain of function mutations in the gene encoding PI3K p110δ were recently associated with a novel combined immune deficiency characterized by recurrent sinopulmonary infections, CD4 lymphopenia, reduced class-switched memory B cells, lymphadenopathy, CMV and/or EBV viremia and EBV-related lymphoma. A subset of affected patients also had elevated serum IgM. Here we describe three patients in two families who were diagnosed with HIGM at a young age and were recently found to carry heterozygous mutations in PIK3CD. These patients had an abnormal circulating B cell distribution featuring a preponderance of early transitional (T1) B cells and plasmablasts. When stimulated in vitro, PIK3CD mutated B cells were able to secrete class-switched immunoglobulins. This finding implies that the patients' elevated serum IgM levels were unlikely a product of an intrinsic B cell functional inability to class switch. All three patients developed malignant lymphoproliferative syndromes that were not associated with EBV. Thus, we identified a novel subset of patients with PIK3CD mutations associated with HIGM, despite indications of preserved in vitro B cell class switch recombination, as well as susceptibility to non-EBV-associated malignancies.
• Journal of clinical immunology.J Clin Immunol.2014 Apr;34(3):272-6. doi: 10.1007/s10875-014-0012-9. Epub 2014 Mar 8.
• Autosomal dominant gain of function mutations in the gene encoding PI3K p110δ were recently associated with a novel combined immune deficiency characterized by recurrent sinopulmonary infections, CD4 lymphopenia, reduced class-switched memory B cells, lymphadenopathy, CMV and/or EBV viremia and EBV
• PMID 24610295

Japanese Journal

• Spontaneous tumor lysis syndrome with resolution of pancytopenia and disappearance of lymphadenopathy in a patient with peripheral T cell lymphoma unspecified

• PARK Sang-Gon,CHUNG Choon-Hae,PARK Chi-Young
• International journal of hematology 93(3), 394-399, 2011-03-01
• NAID 10029534086

• Kawasaki Disease in Mongolia: Results From 2 Nationwide Retrospective Surveys, 1996–2008

• Davaalkham Dambadarjaa,Nakamura Yosikazu,Baigalmaa Davaakhuu,Davaa Gombojav,Chimedsuren Ochir,Sumberzul Nyamjav,Lkhagvasuren Tserenkhuu,Uehara Ritei,Yanagawa Hiroshi,Kawasaki Tomisaku
• Journal of Epidemiology advpub(0), 1106150236, 2011
• … Fever persisting 5 or more days, bilateral conjunctival congestion, and changes of the lips and oral cavity were the most common symptoms, and cervical lymphadenopathy was the least common symptom. …
• NAID 130000796781

Related Links

• lymphadenopathy syndrome - definition of lymphadenopathy ...

syndrome /syn·drome/ (sin´drōm) a set of symptoms occurring together; the sum of signs of any morbid state; a symptom complex. See also entries under disease. Aarskog syndrome , Aarskog-Scott syndrome a hereditary X-linked ...

• Lymphadenopathy syndrome | Online references ...

Lymphadenopathy is a broad term meaning "disease of the lymph nodes", and is often used as a synonym for swollen or enlarged lymph nodes. Common causes of lymphadenopathy are infection, autoimmune disease, or malignancy. ...

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★リンクテーブル★

リンク元	「arc」「リンパ節腫大症候群」
関連記事	「lymphadenopathy」「syndrome」

「arc」

　　[★]

• n.

• アーク、弧、電弧

関

AIDS-related complex、lymphadenopathy syndrome

　 　

「リンパ節腫大症候群」

　　[★]

英

lymphadenopathy syndrome

関

エイズ関連症候群

「lymphadenopathy」

　　[★]

• n.

• リンパ節障害、リンパ節疾患、リンパ節症

　

「syndrome」

　　[★]

• n.

• 症候群