Differential Diagnosis for Supraclavicular Lymphadenopathy
Single Most Likely Diagnosis
- Metastatic cancer: This is often the first consideration due to the high frequency of malignancies presenting with or metastasizing to the supraclavicular lymph nodes. The most common primary sites include the lungs, breasts, and abdominal organs.
Other Likely Diagnoses
- Lymphoma: Both Hodgkin's and non-Hodgkin's lymphoma can present with supraclavicular lymphadenopathy. The diagnosis is often made after biopsy and histopathological examination.
- Tuberculosis: Although less common in some regions, tuberculosis (TB) can cause supraclavicular lymphadenopathy, especially in endemic areas or in individuals with compromised immune systems.
- Sarcoidosis: This systemic granulomatous disease can involve the lymph nodes, including those in the supraclavicular region, and is often associated with other systemic symptoms.
Do Not Miss Diagnoses
- Thoracic aortic aneurysm or dissection: Although rare, these conditions can cause supraclavicular lymphadenopathy due to compression or invasion of the lymph nodes. Missing this diagnosis could be catastrophic.
- Infectious diseases (e.g., HIV, syphilis): Certain infectious diseases can present with lymphadenopathy, including in the supraclavicular region. Early diagnosis is crucial for appropriate management.
- Castleman disease: A rare lymphoproliferative disorder that can present with lymphadenopathy, including in the supraclavicular region, and requires specific treatment.
Rare Diagnoses
- Kikuchi-Fujimoto disease: A rare, self-limiting condition that causes lymphadenopathy, often in the cervical region but can involve the supraclavicular nodes.
- Kimura disease: A chronic inflammatory disorder that can cause lymphadenopathy and eosinophilia, more commonly seen in Asian males.
- Rosai-Dorfman disease: A rare histiocytic disorder that can present with lymphadenopathy, including in the supraclavicular region, and has a variable prognosis.