Differential Diagnosis for Enlarged Neck Lymph Nodes with Night Sweats

Single Most Likely Diagnosis

• Lymphoma: This is a type of cancer that begins in cells of the lymph system, which is part of the immune system. Lymphoma is a common cause of enlarged lymph nodes, especially when accompanied by systemic symptoms like night sweats. The presence of night sweats, a symptom often associated with lymphoma, makes this a leading consideration.

Other Likely Diagnoses

• Tuberculosis (TB): TB is an infectious disease that can cause lymphadenopathy (enlarged lymph nodes) and systemic symptoms such as night sweats. It's a significant consideration, especially in individuals who have been exposed to TB or have risk factors for the disease.
• Mononucleosis (Mono): Caused by the Epstein-Barr virus, mono can lead to swollen lymph nodes and systemic symptoms, including fever and night sweats. It's more common in younger populations.
• HIV Infection: Early stages of HIV infection can present with lymphadenopathy and systemic symptoms like night sweats. Given the potential for severe consequences if left untreated, HIV should be considered in the differential diagnosis.

Do Not Miss Diagnoses

• Metastatic Cancer: Various types of cancer can metastasize to the lymph nodes in the neck, causing enlargement. Night sweats can be a symptom of advanced cancer. Missing a diagnosis of metastatic cancer could have severe consequences for the patient's prognosis and treatment.
• Sarcoidosis: A condition that can cause inflammation in various parts of the body, including the lymph nodes, leading to their enlargement. While less common, sarcoidosis can present with systemic symptoms and requires consideration to avoid missing the diagnosis.

Rare Diagnoses

• Castleman Disease: A rare disorder that involves an overgrowth of cells in the lymphatic system, which can cause lymphadenopathy and systemic symptoms, including night sweats.
• Kikuchi-Fujimoto Disease: A rare, self-limiting condition that causes lymphadenopathy, often accompanied by fever and night sweats. It's more common in young women and typically resolves on its own.
• Kimura Disease: A rare, chronic inflammatory disorder that can cause lymphadenopathy and eosinophilia, sometimes presenting with systemic symptoms like night sweats.

Each of these diagnoses has a different approach to management and treatment, emphasizing the importance of a thorough diagnostic workup to determine the underlying cause of the patient's symptoms.