lymphadenopathy

Viral

HIV, EBV, CMV, HSV, VZV, hepatitis, measles, rubella

Bacterial

Generalized (brucellosis, leptospirosis, TB, atypical mycobacteria, syphilis)

Localized (streptococci, staphylococci, cat-scratch disease, tularemia)

Fungal/parasitic

Histo, coccidio, paracoccidioidomycosis, toxoplasmosis

Immunologic

Collagen vascular disease, drugs (eg, phenytoin), serum sickness, histiocytosis X, Castleman’s and Kawasaki disease

Neoplasm

Lymphoma, leukemia, amyloidosis, metastatic carcinoma

Other

Sarcoidosis; lipid storage diseases

Factors that favor biopsy

Pt >40 y, >2 cm, location (supraclavicular always abnl), duration >1 mo

Consistency (hard vs. rubbery vs. soft) & tenderness are not reliable

Exicisional biopsy preferred over fine needle aspiration (FNA)