From the Guidelines
Palpable elbow lymph nodes are not typically benign and warrant medical evaluation. Lymph nodes in the elbow region (epitrochlear nodes) are not normally palpable, and when they can be felt, this often indicates an underlying pathological process. Common causes include infections (particularly of the hand or forearm), lymphoma, or metastatic cancer. The presence of a palpable axillary lump, as discussed in a study published in the Journal of the American College of Radiology in 2022 1, has a wide differential diagnosis, ranging from nonmalignant etiologies to primary breast malignancy or metastatic disease from a nonbreast malignancy or lymphoma.
Key points to consider when evaluating palpable elbow lymph nodes include:
- The risk of cancer increases with age, as noted in a study where only 7% of women who underwent biopsy for an abnormal node detected on axillary US were found to be malignant 1
- Imaging modalities such as ultrasound or CT scan may be used to evaluate the lymph nodes and underlying tissues
- A diagnostic approach that includes a combination of physical examination, blood tests, and imaging studies is often necessary to determine the underlying cause of the lymph node enlargement
- Treatment depends entirely on the underlying cause, ranging from antibiotics for infection to more complex interventions for malignancies
It is essential to consult a healthcare provider promptly for proper assessment if palpable lymph nodes are noticed in the elbow area, as early diagnosis improves outcomes for most conditions causing lymph node enlargement. The evaluation may include a physical examination, blood tests, imaging studies, and possibly a biopsy if malignancy is suspected.
From the Research
Lymphadenopathy
The presence of palpable elbow lymph nodes can be caused by various factors, including infections, autoimmune diseases, or malignancy.
- Lymphadenopathy is a common finding on physical examination in the pediatric population and is often physiologic, but it can also be associated with more serious illnesses 2.
- In children with refractory symptoms, lymph node biopsy may be indicated to rule out malignancy or obtain material for culture 3.
- Lymphoma, a group of malignant neoplasms of lymphocytes, typically presents as painless adenopathy, with systemic symptoms of fever, unexplained weight loss, and night sweats occurring in more advanced stages of the disease 4.
Benign Causes
- Lymphadenitis in the pediatric population frequently is benign and self-limited, often caused by infections 3.
- Reactive lymphadenopathies can be caused by infections, autoimmune diseases, or other non-malignant conditions 3.
- Tuberculosis can also cause lymphadenopathy, particularly in the neck region, and can be a diagnostic challenge 5.
Evaluation and Diagnosis
- A thorough clinical history, physical examination, laboratory studies, and imaging can help narrow down the differential diagnosis of lymphadenopathy 2.
- Lymph node biopsy may be necessary to determine the cause of lymphadenopathy, especially if malignancy is suspected 4, 3.
- The pattern of diseases causing lymphadenopathies can vary depending on the population being studied, and clinicians should be aware of the common causes of lymphadenopathy in their patient population 6.