hilar lymphadenopathy

肺門リンパ節腫脹

WordNet

1. chronic abnormal enlargement of the lymph nodes (usually associated with disease)
2. of or relating to or located near a hilum

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/12/22 12:14:08」(JST)

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Lymphadenopathy

Neck lymphadenopathy associated with infectious mononucleosis
ICD-10	I88, L04, R59.1
ICD-9	289.1-289.3, 683, 785.6
DiseasesDB	22225
MedlinePlus	001301
eMedicine	ped/1333
MeSH	D008206

Lymphadenopathy refers to lymph nodes which are abnormal in size, number or consistency and is often used as a synonym for swollen or enlarged lymph nodes. Common causes of lymphadenopathy are infection, autoimmune disease, or malignancy.

Inflammation as a cause of lymph node enlargement is known as lymphadenitis. In practice, the distinction between lymphadenopathy and lymphadenitis is rarely made. Inflammation of the lymphatic vessels is also 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").

Types

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

• 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
• Dermatopathic lymphadenopathy: lymphadenopathy associated with skin disease.

Causes

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. 肺サルコイドーシスの臨床症状および診断 clinical manifestations and diagnosis of pulmonary sarcoidosis
• 2. 非ホジキンリンパ腫の評価および病期分類 evaluation and staging of non hodgkin lymphoma
• 3. 結節性紅斑 erythema nodosum
• 4. 肺結核の臨床症状および評価 clinical manifestations and evaluation of pulmonary tuberculosis
• 5. 小児における非結核性抗酸菌性肺感染症の概要 overview of nontuberculous mycobacterial pulmonary infections in children

English Journal

• Clinical Manifestations of Patients With Intraocular Inflammation and Positive QuantiFERON-TB Gold In-Tube Test in a Country Nonendemic for Tuberculosis.

• La Distia Nora R1, van Velthoven ME2, Ten Dam-van Loon NH3, Misotten T2, Bakker M4, van Hagen MP5, Rothova A6.Author information 1Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands; Department of Ophthalmology, University of Indonesia & Cipto Mangunkusumo Hospital Kirana, Jakarta, Indonesia.2Rotterdam Eye Hospital, Rotterdam, Netherlands.3Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands.4Department of Pulmonary Diseases, Erasmus Medical Center, Rotterdam, Netherlands.5Department of Clinical Immunology, Erasmus Medical Center, Rotterdam, Netherlands.6Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands. Electronic address: a.rothova@erasmusmc.nl.AbstractPURPOSE: To evaluate clinical manifestations of patients with uveitis and scleritis of unknown origin and positive QuantiFERON-TB Gold In-Tube test (quantiferon) in a country not endemic for tuberculosis.
• American journal of ophthalmology.Am J Ophthalmol.2014 Apr;157(4):754-61. doi: 10.1016/j.ajo.2013.11.013. Epub 2013 Nov 18.
• PURPOSE: To evaluate clinical manifestations of patients with uveitis and scleritis of unknown origin and positive QuantiFERON-TB Gold In-Tube test (quantiferon) in a country not endemic for tuberculosis.DESIGN: Multicenter retrospective cohort study.METHODS: Retrospective review of the clinical, la
• PMID 24262781

• A rare case of anaplastic variant of diffuse large B-cell lymphoma presenting as a lung primary.

• Kos Z1, Burns BF, Gomes MM, Sekhon HS.Author information 11University of Ottawa, Ottawa, Ontario, Canada.AbstractPrimary pulmonary lymphoma is an uncommon neoplastic disorder representing approximately 0.5% to 1% of primary pulmonary malignancies. The vast majority are of low-grade, mucosa-associated lymphoid tissue type. Primary diffuse large B-cell lymphoma of the lung is rare, though cases of the centroblastic and immunoblastic variants have been described. We present herein an interesting case of an 80-year-old man who presented with both respiratory and constitutional symptoms and was found to have a 4.5 cm left hilar mass with bilateral hilar and mediastinal lymphadenopathy on imaging. Endobronchial biopsy revealed an aggressive large cell lymphoma, with scattered large, bizarre-shaped nuclei resembling Reed-Sternberg cells, positive for CD20, PAX5, CD30, and MUM-1, consistent with an anaplastic variant of diffuse large B-cell lymphoma. Imaging showed no evidence of extrathoracic disease. Standard treatment with cyclophosphamide/vincristine/prednisone and rituximab resulted in significant clinical and radiological response and the patient remains in remission 21 months later. To the best of our knowledge, this modified Ann Arbor stage II2E primary pulmonary lymphoma, is the first description in the English literature of anaplastic variant of diffuse large B-cell lymphoma presenting as a lung primary.
• International journal of surgical pathology.Int J Surg Pathol.2014 Apr;22(2):167-71. doi: 10.1177/1066896913491318. Epub 2013 Jun 17.
• Primary pulmonary lymphoma is an uncommon neoplastic disorder representing approximately 0.5% to 1% of primary pulmonary malignancies. The vast majority are of low-grade, mucosa-associated lymphoid tissue type. Primary diffuse large B-cell lymphoma of the lung is rare, though cases of the centroblas
• PMID 23775019

• Age-related differences in chest radiographic staging of sarcoidosis in Japan.

• Sawahata M1, Sugiyama Y, Nakamura Y, Nakayama M, Mato N, Yamasawa H, Bando M.Author information 1Dept of Medicine, Jichi Medical University, Shimotsuke, Tochigi.AbstractTo the Editor:Sarcoidosis is generally thought to occur more frequently in adults <40 years of age, with incidence peaking in patients aged between 20 and 29 years 1. In Japan, as well as in Europe, there is a second peak in females >50 years of age 2, 3. When comparing the results of national epidemiological surveys conducted in Japan between 1960 and 2004, the incidence rate in females >50 years of age can be seen to have gradually increased while that for bilateral hilar lymphadenopathy (BHL) has decreased 3. However, whether there is any association between these trends in Japan remains to be elucidated. An earlier study conducted in Europe suggested that older patients are less likely to present with stage 1 sarcoidosis at diagnosis 2. Against this background, in this study, we aimed to identify the age-related differences in chest radiographic staging of sarcoidosis in Japan.We reviewed 588 consecutive Japanese patients newly diagnosed with sarcoidosis (431 biopsy proven and 157 clinically proven) who were admitted to or underwent bronchoscopy between April 1974 and July 2012 at Jichi Medical University Hospital (Tochigi, Japan). The diagnosis was made based on the diagnostic criteria and guidelines for sarcoidosis developed by the Japanese Society of Sarcoidosis and Other.
• The European respiratory journal.Eur Respir J.2014 Mar 13. [Epub ahead of print]
• To the Editor:Sarcoidosis is generally thought to occur more frequently in adults <40 years of age, with incidence peaking in patients aged between 20 and 29 years 1. In Japan, as well as in Europe, there is a second peak in females >50 years of age 2, 3. When comparing the results of national
• PMID 24627539

Japanese Journal

• 気管分岐部および右上葉支・中間幹分岐部に2本のYステントを留置した小細胞肺癌の1例

• 坪井 理恵,村上 靖,船橋 依理子,足立 崇,岡 さおり,龍華 美咲,小暮 啓人,北川 智余恵,沖 昌英,坂 英雄
• 気管支学 : 日本気管支研究会雑誌 34(2), 139-143, 2012-03-25
• 背景.気道狭窄に対するシリコンステント留置は,速やかに気道を確保する方法として近年広く普及しており,多彩なデバイスや手技が存在する.気管分岐部の狭窄に対してはDumon^[○!R] Y-stent(Tracheobronxane^<TM> Y ; No-vatech ; La Ciotat, France)が頻用されている.今回,中枢気道狭窄症状により発症し,気管分岐部および右上葉支・ …
• NAID 110009437394

• 我が国におけるサルコイドーシス組織診断群からみた眼サルコイドーシスの国際基準案の検討 (シンポジウム 国際眼科診断基準)

• 岩橋 千春,大黒 伸行
• 日本サルコイドーシス/肉芽腫性疾患学会雑誌 32(1), 71-77, 2012
• NAID 40019449923

Related Links

• Hilar lymphadenopathy | definition of hilar lymphadenopathy ...

lymphadenopathy [lim-fad″ĕ-nop´ah-the] disease of the lymph nodes; called also adenopathy. angioimmunoblastic lymphadenopathy (angioimmunoblastic lymphadenopathy with dysproteinemia (AILD)) a systemic disorder resembling ...

• Chest Radiology - University of Virginia

Chest Radiology > Pathology > Hilar Adenopathy Hilar Adenopathy Enlargement of the lymph nodes within the lung hilum can be an important finding for underlying pathology. A differential of possible etiologies can be broken up into ...

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★リンクテーブル★

リンク元	「KAP STEP2CK2008 002」
拡張検索	「bilateral hilar lymphadenopathy」
関連記事	「lymphadenopathy」「hilar」

「KAP STEP2CK2008 002」

　　[★]

glossary

• lancinating
• throbbing
• hilar lymphadenopathy
• vitiligo
• alopecia areata 円形脱毛症
• trichotillomania
• psyllium おおばこか オオバコ。緩下薬らしい
• Coxsackie virus 手足口病
• indolent 無痛性
• commensals 共生
• actinomycetes 放線菌

サルコイドーシス

• 疫学

• peak age group for sarcoidosis is 20-40
• more common in blacks
• African Americanがヒント

病態

• lungs, heart, kidneys, skin, liver, or other organ

• uveitisも来す？
• 冒されやすい部位は皮膚、眼、肺

亜急性甲状腺炎

• 病原体：ウイルス

橋本病

• Many patients also have other autoimmune diseases.
• ホルモンの変化：hypothyroidism are also present in longer-standing cases. Early in the disease, as in this case, T4 and TSH levels may be normal.
• MPO抗体は橋本病に特異的ではない；Graves disease and silent lymphocytic thyroiditisでも上がる

円形脱毛症

• 円形脱毛症と他の疾患の関連：autoimmune disorders, such as Hashimoto thyroiditis, pernicious anemia, and Addison disease
• 皮膚科的特徴：exclamation hair

http://www.aafp.org/afp/2003/0701/p93.html

• 治療：triamcinolone or application of anthralin ointment has been beneficial in hastening recovery

プロペシア

• フィナステリドは、5α-還元酵素II型を選択的に抑制することによりテストステロンからジヒドロテストステロンへの変換を阻害し、発毛作用を示すものと考えられる。

http://www.info.pmda.go.jp/go/pack/249900XF1021_2_01/249900XF1021_2_01?view=body

同名半盲

• bilateral temporal hemianopia and is due to chiasmatic lesions that compromise the crossing fibers originating from the temporal retina

単純ヘルペスウイルスの初感染患者について

• Gingivostomatitis and pharyngitis are the most frequent clinical manifestations of primary herpes simplex virus 1 infection, and are most commonly seen in children and young adults. Clinical signs and symptoms include fever, malaise, myalgias, and cervical adenopathy. Common lesions may involve the hard and soft palate, gingiva, tongue, lips, and facial area.

放線菌について

• Actinomyces israelii causes an indolent suppurative infection.

「bilateral hilar lymphadenopathy」

　　[★] 両側肺門リンパ節腫脹, BHL

「lymphadenopathy」

　　[★]

• n.

• リンパ節障害、リンパ節疾患、リンパ節症

　

「hilar」

　　[★]

門部の

関

hilar region、hilus