PERSONAL PRACTICE Lymphadenopathy

Lymph node enlargement is a common finding on routine physical examination of children. The dilemma facing general practitioners is when to refer to paediatricians; the dilemma for paediatricians is deciding how extensively to investigate children. While the majority of cases will have a benign, rapidly resolving course, the well recognised associations of lymphadenopathy and potentially life threatening diseases such as cancer cause worry and anxiety to both families and doctors caring for children. This concern may in itself initiate an inappropriately rapid or over aggressive attempt at determining the diagnosis. An organised approach to children with lymphadenopathy will help the clinician make appropriate decisions regarding treatment and further investigation.