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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