Cervical Lymphadenopathy

The neck region contains around 300 lymph nodes (LNs) out of 800 LNs in the whole body. Cervical lymphadenopathy (CLA) refers to cervical nodal tissue measuring more than 1 cm in diameter. However, palpable supra-clavicular nodes of any size are considered abnormal. It is not a disease by itself; rather, it is a sign of an underlying pathology that ranges from a trivial infection to a metastatic malignant neoplasm. Cervical lymphadenopathy may be classified according to its etiology into malignant, infectious, autoimmune, miscellaneous, and iatrogenic (due to medications). Pathologically, CLA may be due to lymphoid hyperplasia or infiltration. Clinically, based on distribution, CLA may be localized (only one area is involved), regional (two or more contagious areas are involved), or part of generalized adenopathy (two or more noncontiguous areas are involved). Based on the duration, CLA is further classified into acute (2 weeks duration), sub-acute (2–6 weeks duration), and chronic (does not resolve by 6 weeks). This chapter discusses the clinical presentation, diagnosis, differential diagnosis, and management of the different pathologies causing CLA. In addition, it describes in detail the technique of modified radical neck dissection.