A patient with enlarged lymph node may be managed by either observation or biopsy of the lymph node.


Indications for biopsy of the enlarged lymph node - any of the following:

(1) patient age > 40 years

(2) supraclavicular lymph node

(3) diameter > 2 cm

(4) nontender

(5) rock hard consistency

(6) fixed and matted together

(7) persistence > 2 weeks


If none of the indications are present then the patient can be observed for 2-4 weeks.


NOTE: These criteria for identification of a malignant disease involving a lymph node. It may be appropriate to biopsy a lymph node for evaluation of an infectious disease, for example a patient with fever and diffuse lymphadenopathy.


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