The clinical evaluation of lymphadenopathy

The evaluation of lymphadenopathy is a diagnostic challenge for the primary care physician because of the expansive differential diagnosis, including both benign and malignant conditions. In most cases, the history and physical examination provide enough information to identify a specific etiology. When the diagnosis is uncertain, selective laboratory tests are warranted. The most important imaging test is the chest radiograph; the clinician's abilities to appreciate subtle radiographic changes and communicate with the radiologist are invaluable. Finally, knowing when and how to perform a lymph node biopsy is crucial. The obstetrician/gynecologist, in providing continuity of care, is in an ideal position to investigate, diagnose, and treat lymphadenopathy.