Materiały źródłowe

• #1 Lymphadenopathy: Differential Diagnosis and Evaluation | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/1015/p1313.html

  Our understanding of the epidemiology of lymphadenopathy in family practice is limited by the scarcity of relevant literature. Only one study provides reliable population-based estimates. Findings from this Dutch study revealed a 0.6 percent annual incidence of unexplained lymphadenopathy in the general population. Of 2,556 patients in the study who presented with unexplained lymphadenopathy to their family physicians, 256 (10 percent) were referred to a subspecialist and 82 (3.2 percent) required a biopsy, but only 29 (1.1 percent) had a malignancy. […] This low prevalence of malignancy is supported by the results of two case series from family practice departments in the United States, in which none of 80 patients and three of 238 patients with unexplained lymphadenopathy were diagnosed with malignancy. In contrast, the prevalence of malignancy in lymph node biopsies performed in referral centers is 40 to 60 percent, a statistic that has made its way into many textbooks. […] In primary care settings, patients 40 years of age and older with unexplained lymphadenopathy have about a 4 percent risk of cancer versus a 0.4 percent risk in patients younger than age 40.

• #2 Generalised Lymphadenopathy (Swollen Glands) | Doctor

  https://patient.info/doctor/generalised-lymphadenopathy

  General lymphadenopathy epidemiology1 […] In primary care unexplained lymphadenopathy has an annual incidence of 0.6%. […] Fewer than 1 in 100 of these cases have a malignant aetiology, but this increases as the age of the patient increases. 4% of patients aged 40 years or older who present with unexplained lymphadenopathy are found to have an underlying cancer, but for those younger than 40 years this falls to 0.4%. […] […] […] The most important aspect of management is the recognition and exclusion of serious disease, which can often mimic trivial self-limiting conditions in the early stages. […] […] […] Patients and parents should be advised to seek further advice if lymph node enlargement does not resolve, new enlargements develop, old symptoms persist or new ones appear.

• #3 Adenopathy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK558918/

  A Dutch study also revealed that of 2556 patients that presented with unclear lymphadenopathy to their family physicians, 10% were referred for a biopsy, and only 1.1% were found to be related to malignancy. […] These findings are mirrored by two case series completed in family practice departments within the United States that demonstrated that 0 of 80 patients and 3 of 238 patients had malignant causes of lymphadenopathy, respectively. […] It is important to remember that endemic regions such as South Africa or India have increased rates of lymphadenopathy due to tuberculosis, parasitic infections, and HIV.

• #4 Lymphadenopathy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513250/

  Broad generalities can safely be made about the epidemiology of lymphadenopathy. First, generalized and localized lymphadenopathies are equally distributed without regard to gender. Second, lymphadenopathy is more prevalent in the pediatric population than in the adult population, secondary to the more significant number of viral infections. It would follow that most of the time, lymphadenopathy in the pediatric population is of less consequence, secondary to the prevalence of viral and bacterial infections in that age group. Three-quarters of all lymphadenopathy observed are localized; of those three-quarters, half are localized to the head and neck area. All remaining localized lymphadenopathy is found in the inguinal area, and the remaining lymphadenopathy is located in the axilla in the supraclavicular area. Of note, the differential diagnosis of lymphadenopathy changes significantly with the patient’s age. Third, the patient’s location and circumstances are very revealing, as well as lymphadenopathy. For example, in the developing world (sub-Saharan Africa, Southeast Asia, Indian subcontinent), exposure to parasites, HIV, and miliary tuberculosis are far more likely to be causes of generalized lymphadenopathy than in the United States and Europe. Whereas, Epstein-Barr virus, streptococcal pharyngitis, and some neoplastic processes are more likely candidates to cause lymphadenopathy in the United States and the remainder of the localized industrial world. An exposure history is significant for diagnosis.

• #5 Pediatric Lymph Node Disorders: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/937855-overview

  Lymphadenopathy is frequent in children, so much so that pinpointing its exact prevalence is challenging. Most cases are benign, with age playing a crucial role in its epidemiology. The probability of finding enlarged lymph nodes grows with age and exposure, making benign lymphadenopathy more commonly observed in children than in adults. […] The prevalence of malignancy among children with lymphadenopathy managed in the primary care setting is approximately 5%; however, this figure rises to 13-49% among children with suspected malignancy who have undergone biopsy in pediatric referral centers. Malignant disease is often due to leukemia in younger children and to Hodgkin disease in adolescents. […] The risk of malignancy increases with worrisome features such as systemic (B) symptoms (fever 1 wk, weight loss 10%, night-time sweating), fixed and nontender lymph nodes, lymph nodes having a diameter greater than 2 cm and not responding to antibiotic therapy, unusual locations (eg, supraclavicular or mediastinal), generalized lymphadenopathy, and unexplained abnormal laboratory results such as pancytopenia, persistently elevated erythrocyte sedimentation rate (ESR), and highly elevated lactate dehydrogenase (LDH) levels.

• #6 Lymphadenopathy: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/956340-overview

  Lymphadenopathy reflects disease involving the reticuloendothelial system, secondary to an increase in normal lymphocytes and macrophages in response to an antigen. Most lymphadenopathy in children is due to benign, self-limited disease such as viral infections. Other, less common etiologies responsible for adenopathy include nodal accumulation of inflammatory cells in response to an infection in the node (lymphadenitis), neoplastic lymphocytes or macrophages (lymphoma), or metabolite-laden macrophages in storage diseases (Gaucher disease). […] The precise incidence of lymphadenopathy is not known, but estimates of palpable adenopathy in childhood vary from 38-45%, and lymphadenopathy is one of the most common clinical problems encountered in pediatrics. Determining whether adenopathy is simply a normal response to frequent viral infections within an age group or if it is significant enough to consider more serious underlying disease is often difficult.

• #7 Adenopathy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK558918/

  A majority of patients with lymphadenopathy will have a benign etiology. Age is an important factor in characterizing the epidemiology of lymphadenopathy, and thus, can be divided into children and adults. […] Children more commonly appear to have benign causes of lymphadenopathy. To better understand this, a study completed by Knight PJ et al. reviewed 239 children who underwent a peripheral node biopsy and found that the most common etiology noted was reactive hyperplasia of unknown etiology, followed by granulomatous infections, cancer, and dermatopathic lymphadenopathy. […] Adults also appear to have a low prevalence of malignancy. To further characterize this, a study was completed in a family practice setting where only 3% of 249 patients with lymphadenopathy underwent biopsies. Of these patients, no one was found to have a debilitating illness.

• #8 Lymphadenopathy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513250/

  Statistics concerning lymphadenopathy are inaccurate as the great majority of lymphadenopathy is caused by a non-reportable illness and thus not reported or taken into account. This results in a statistical bias, or skew, toward the reportable causes of lymphadenopathy: malignancies, HIV, tuberculosis, and sexually transmitted infections. Citations in the recent literature for general medical practice indicate that less than 1% of people with lymphadenopathy have malignant disease, most often due to leukemia in younger children, Hodgkin disease in adolescence, non-Hodgkin disease, and chronic lymphocytic leukemia in adults. It has been reported the general prevalence of malignancy is 0.4% in patients under 40 years and around 4% in those older than 40 years of age seen in a primary care setting. It is reported that the prevalence rate of neoplastic disease rises to nearly 20% in referral centers and rises to 50% or more in patients with initial risk factors.

• #9 Generalised Lymphadenopathy (Swollen Glands) | Doctor

  https://patient.info/doctor/generalised-lymphadenopathy

  […] […] The following additional features of lymphadenopathy are suspicious should trigger further investigation and/or referral: […] Persistence for six weeks or more. […] Lymph nodes increasing in size. […] Lymph nodes greater than 2 cm in size. […] Widespread nature. […] Associated splenomegaly, night sweats or weight loss. […] […] […] Depending on the suspected underlying condition, referral to a paediatric infectious disease specialist, a surgeon, a haematologist or an oncologist may be required.

• #10 Lymphadenopathy

  https://umcno.staywellsolutionsonline.com/Library/DiseasesConditions/Adult/Allergy/3,90469

  Lymphadenopathy is swelling of the lymph nodes. Lymph nodes are small, bean-shaped glands around the body. […] Lymphadenopathy is very common. The glands often get larger during a viral or bacterial infection. […] The neck (cervical) lymph nodes are the most common site of lymphadenopathy. […] Lymphadenopathy can also be caused by: Infection of a lymph node or small group of nodes (lymphadenitis). […] Enlarged lymph nodes are often near the source of infection. […] You may be advised to have diagnostic tests and to see a specialist. […] The treatment of enlarged lymph nodes depends on the cause. Enlarged lymph nodes are often harmless and go away without any treatment.

• #11 Epidemiology of laryngeal and hypopharyngeal cancer in…

  https://otolaryngologypl.com/seo/article/01.3001.0000.6806/en

  Swollen lymph nodes in the neck were found in 52.4% of the patients, most often N2 (37.4%). […] Swollen lymph nodes were statistically relevantly more frequent in patients with supraglottic or hypopharynx tumour.

• #12 Lymphadenopathy: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/956340-overview

  In the United States, common viral and bacterial infections are overwhelmingly the most common cause of adenopathy. Infectious mononucleosis and cytomegalovirus (CMV) are important etiologies, but adenopathy is usually caused by common viral upper respiratory tract infections. Localized lymphadenitis is most often caused by staphylococci and beta-hemolytic streptococci. […] Infections that are rarely observed in the United States, such as tuberculosis, typhoid fever, leishmaniasis, trypanosomiasis, schistosomiasis, filariasis, and fungal infections, are common causes of lymphadenopathy in developing nations. HIV infections must be strongly considered in areas of high incidence. […] In the United States, mortality and serious morbidity caused by adenopathy are unusual given the common infectious etiologies. Malignancies, such as leukemia, lymphomas, and neuroblastoma, are the primary causes of mortality in the United States. Significant morbidity and mortality are also associated with autoimmune disorders (eg, juvenile rheumatoid arthritis, systemic lupus erythematosus), histiocytoses, and storage diseases.

• #13 Clinical Overview of Mumps | Mumps | CDC

  https://www.cdc.gov/mumps/hcp/clinical-overview/index.html

  Mumps is a contagious disease that can be serious to both children and adults. The best protection against measles is the MMR vaccine. […] Prior to vaccinae introduction: Before the U.S. mumps vaccination program started in 1967, about 186,000 cases were reported each year, and many more unreported cases occurred. […] Post-vaccine era: Following the implementation of the routine two-dose MMR vaccination policy, there was a 99% decrease in U.S. mumps cases; with just a few hundred cases reported each year by the early 2000s. […] However, starting in 2006 there has been an increase in mumps cases with several peak years. […] The majority of cases and outbreaks occur among people who are fully vaccinated and in close-contact or congregate settings. […] From year to year, the number of U.S. mumps cases can range from a couple hundred to a couple thousand. Some years have more cases than usual because of large outbreaks. […] When mumps cases or an outbreak occur, state and local health departments have the lead in investigating the outbreak. […] Mumps is a nationally notifiable disease, and all cases should be reported to the state or local health department.

• #14 Mumps – Health Protection Surveillance Centre

  https://www.hpsc.ie/a-z/vaccinepreventable/mumps/

  Mumps is a notifiable disease. […] National Notifiable Disease Hub – data dashboards displaying data on trends and key epidemiological features for notifiable infectious diseases reported in Ireland. […] Surveillance Reports. […] Surveillance Forms. […] Guidance. […] Publications. […] Case Definition.

• #15 For health professionals: Listeriosis (Listeria) – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/listeriosis/health-professionals-listeriosis.html

  Invasive listeriosis is a national notifiable disease. All health professionals are to report cases to their provincial or territorial public health authorities. […] Health professionals in Canada play a critical role in identifying and reporting cases of listeriosis. See the surveillance of listeriosis section for more information on surveillance in Canada.

• #16 Factsheet about mumps

  https://www.ecdc.europa.eu/en/mumps/facts

  Mumps case definition for the purpose of epidemiological surveillance. Europe-wide mumps incidence rates can be found in ECDCs Annual epidemiological report on communicable diseases in Europe. ECDC also monitors European mumps outbreaks through epidemic intelligence and reports on them through the Communicable Disease Threat Reports (CDTR). […] Immunisation against mumps has been associated with a marked decline in the incidence of mumps disease in the EU/EEA. Despite high-vaccination rate in the EU/EEA, mumps outbreaks have been reported in vaccinated communities, particularly in close-contact settings such as schools, colleges, and camps. However, high and sustained vaccination coverage helps limit the size, length, and spread of outbreaks.

• #17 Swollen Glands and Covid: Are they Related? Learn More

  https://my.klarity.health/swollen-glands-and-covid/

  Swollen glands are fairly common in patients who get infections. For example, a cold or flu may lead to swollen glands in the neck or under the jaw. […] Swollen glands are not listed as one of the symptoms of Covid-19 as described by the NHS. However, it is important to be mindful of the causes of swollen glands and their management because swollen glands could be an indication of an infection or a chronic illness. […] It is believed that swollen glands are a rare symptom although there have been reports of people with Covid-19 experiencing swollen glands. The reason is that Covid-19 symptoms can vary from person to person. […] In addition to the swollen glands experienced by some Covid-19 patients, it has been reported that the Covid-19 vaccine may in some cases lead to swollen glands. […] Having swollen glands after receiving the Covid-19 vaccine is not a common side effect. […] Therefore, swollen lymph nodes, post-vaccination, normally mean nothing worrisome – it shows that the vaccine is effective enough to activate and train your immune system.

• #18 Lymphoma: Symptoms, Causes and Treatment

  https://my.clevelandclinic.org/health/diseases/22225-lymphoma

  A swollen lymph node may be a sign of lymphoma. […] The American Cancer Society estimates 89,000 people in the U.S. will be diagnosed with lymphoma in 2023. […] Non-Hodgkin typically affects ages 60 to 80. […] Hodgkin lymphoma may affect people between the ages of 20 to 39 and at or over age 65. […] Researchers continue to identify lymphoma risk factors. […] Talk to your healthcare provider if you think your medical history or family medical history might increase your risk of developing lymphoma. […] Overall, survival rate data show 89% of people with Hodgkin lymphoma and 74% of people with non-Hodgkin lymphoma were alive five years after diagnosis. […] Blood tests may detect issues like having a high white blood cell count that may be a sign of lymphoma, leukemia or other blood cancers. But they dont detect lymphoma. Healthcare providers diagnose lymphoma based on biopsy and imaging tests results. […] The most common early symptom is swollen lymph nodes in your neck, upper chest, armpit, belly or groin.

• #19 Prostate cancer and the lymph nodes | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/prostate-cancer/prostate-cancer-and-the-lymph-nodes

  If prostate cancer cells spread to the lymph nodes, they usually go to the nodes close to the prostate. […] In early prostate cancer, the cells have not spread to the lymph nodes. […] Locally advanced prostate cancer may have spread to the lymph nodes that are close to the prostate. […] In advanced prostate cancer, there are usually cancer cells in the lymph nodes close to the prostate and in lymph nodes further away.

• #20

  https://www.today.com/health/woman-thinks-swollen-glands-are-stress-had-thyroid-cancer-t161275

  Thyroid cancer is common in women, Sinclair said. About 50,000 people a year are diagnosed and it affects women about three times as often as men. […] Though it’s a common symptom, having a swollen lymph node doesn’t necessarily mean that a person has cancer. […] Of the people we see with (enlarged) lymph nodes in their neck, most of them won’t have a malignancy, Sinclair said. […] Many people with thyroid cancer have what seem like swollen lymph nodes or nodules in the neck and Cogan’s proactive behavior helped doctors catch it early. […] The most common symptom that we see with thyroid cancer include the lump in the neck, like Aubrie, Sinclair explained. […] But these signs are normally found when the cancer is larger and invading, according to Sinclair. […] One of the factors that influences whether the cancer comes back is the number of lymph nodes involved, Sinclair explained.

• #21 Sialadenitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/sialadenitis?lang=us

  Sialadenitis refers to inflammation of the salivary glands. It may be acute or chronic and has a broad range of causes. […] Other conditions related to sialadenitis include: Sjgren syndrome: chronic sialadenitis, Mikulicz syndrome: chronic sialadenitis, post-radiation: post-irradiative sialadenitis, iodine-131 administration, HIV-associated sialadenitis or immune reconstitution inflammatory syndrome (IRIS), often presenting with bilateral parotid swelling. […] Due to calculi being a dominant etiological factor, the distribution of sialadenitis follows that of sialolithiasis and therefore the submandibular glands are the most commonly affected (approximately 85%) as the submandibular ducts have more of an upward course and the secreted saliva has a higher viscosity.

• #22 (PDF) Epidemiology of Salivary Gland Infections

  https://www.academia.edu/27771361/Epidemiology_of_Salivary_Gland_Infections

  This paper discusses the epidemiology of salivary gland infections, primarily focusing on sialadenitis, which can be caused by bacterial or viral infections. It highlights a significant shift in the incidence and management of sialadenitis due to advancements in hygiene and antibiotics. Mumps is emphasized as a notable viral infection affecting salivary glands, with its potential complications for both children and adults being outlined. […] Acute salivary gland infections (ASI) have been associated with poor outcome in elderly and postoperative patients. […] In total, 157 patients with ASI were included. The parotid gland (PG) was affected in 89 (57%) cases and the submandibular gland (SMG) in 68 (43%) cases. […] The literature describes several different classifications and denominations for chronic sialadenitis of the parotid gland.

• #23 Mesenteric adenitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/mesenteric-adenitis?lang=us

  Mesenteric adenitis is most common in children and adolescents although it may occasionally affect adults. […] Yersinia enterocolitica is considered the most common pathogen in temperate Europe, North America and Australia. It is more common in boys.

• #24 Palpable cervical lymph nodes (Paediatric Guidelines) | Right Decisions

  https://rightdecisions.scot.nhs.uk/tam-treatments-and-medicines-nhs-highland/paediatric-therapeutic-guidelines/palpable-cervical-lymph-nodes-paediatric-guidelines/

  Palpable cervical lymph nodes are a common clinical finding in children. Palpable nodes are often physiological or reactive from viral infections and often do not require further investigation or referral. […] Lymphadenopathy refers to an abnormal lymph node(s). This may be an increase in the size or number of lymph nodes, or a change in node consistency. It is important to make a clear distinction between normal palpable nodes and lymphadenopathy, in order to avoid over-investigation and unwarranted parental concern. […] The most common cause of palpable cervical nodes is enlarged nodes as a response to infection; commonly an URTI, or systemic viral illness. […] Lymph nodes may be a site for infection, including bacterial lymphadenitis, mycobacterium tuberculosis, atypical mycobacterium or cat scratch disease (Bartonella). […] Though uncommon, Kawasaki disease and PIMS-TS are possible causes of cervical lymphadenopathy. […] Leukaemia, lymphoma, thyroid cancer and neuroblastoma may all be associated with cervical lymphadenopathy. Isolated cervical lymphadenopathy is, though possible, rarely a result of cancer.

• #25 Long COVID and Salivary Glands (SARS-CoV-2 and Sialadenitis and Xerostomia) | Iowa Head and Neck Protocols

  https://medicine.uiowa.edu/iowaprotocols/long-covid-and-salivary-glands-sars-cov-2-and-sialadenitis-and-xerostomia

  Xerostomia is a common complaint – identified by Villa (2015) to occur in 5.5% to 46% of the population. It occurs more commonly in women and the elderly with multiple causes including the common use of xerogenic medication, systemic disease (endocrine/autoimmune/infectious/granulomatous) and local factors (radiation/lifestyle) (Millsop 2017) […] Through systematic review, Tsuchiya et al (2023) identified salivary secretory sequelae to COVID – defined by terms: dry mouth, hyposalivation, xerostomia -were „reported by 2-40% of COVID-19 survivors followed up to 28-230 days” […] The prevalence of dry mouth of 14.4% was reported by Biadsee et al in 97 subject assessed 8 months after recovery from COVID-19 (Biadsee 2021) […] Another study identified an overall high prevalence (~30%) of xerostomia among 100 patients 7 months after recovery from infection but no statistically significant difference the proportion with xerostomia when comparing those whose COVID symptoms were mild (25.7%), severe (19.5%) and critical (37.5%) (Anaya 2021)

• #26 Long COVID and Salivary Glands (SARS-CoV-2 and Sialadenitis and Xerostomia) | Iowa Head and Neck Protocols

  https://medicine.uiowa.edu/iowaprotocols/long-covid-and-salivary-glands-sars-cov-2-and-sialadenitis-and-xerostomia

  The COVID variants Alpha, Beta, Gamma and Delta have been reported to be associated with xerostomia more commonly than the Omicron variant – with xerostomia rarely reported after an Omicron variant infection (Jia 2022, Tsuchiya 2023) […] Estimates regarding the prevalence of non-tumor salivary gland swelling are largely imprecise and likely under-reported. A evaluation by Urek et al (2021) of a national health data set in Poland from 2010 to 2019 identified 230,000 patients with 'salivary gland pathologies” of whom 85% were non-neoplastic (Urek 2021) […] These investigators suggested that the prevalence of salivary gland inflammatory lesions is about 1.2% of the general population and identified that salivary stones are responsible for up to 50% of such inflammatory sialadenitis. Varying estimates identify salivary gland stones to affect 1% of the population via autopsy study (Williams 1999), 1 per 15,000 to 30,000 population based on an English hospital admission statistical analysis (Escudier 1999) and an incidence of 1 per 10 – 20,000 population as a personal observation by Dr. Marchal (Marchal 2003)

Zobacz więcej