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 lung, breast, and gastrointestinal tract cancers.
Other Likely Diagnoses
- Infections (tuberculosis, histoplasmosis, etc.): These can cause lymphadenopathy, including in the supraclavicular region, especially in endemic areas or in immunocompromised patients.
- Lymphoma: Both Hodgkin's and non-Hodgkin's lymphoma can present with supraclavicular lymphadenopathy, and it's a common site for lymphoma involvement.
- Autoimmune disorders (e.g., rheumatoid arthritis, lupus): Though less common, these conditions can also lead to lymphadenopathy, including in the supraclavicular area.
Do Not Miss Diagnoses
- Thoracic aortic aneurysm or dissection: Though rare, this condition can cause supraclavicular lymphadenopathy due to compression or invasion of lymph nodes and is critical to diagnose promptly due to its high mortality rate.
- Pulmonary embolism: In rare cases, a pulmonary embolism can cause lymphadenopathy if it leads to infarction and subsequent inflammatory response.
- Malignant lymphadenopathy from a rare primary site (e.g., testicular cancer): Certain cancers that are less common or have a high propensity to metastasize to unusual sites can present with supraclavicular lymphadenopathy.
Rare Diagnoses
- Castleman disease: A rare disorder that involves an overgrowth of cells in the lymph nodes, which can present with lymphadenopathy, including in the supraclavicular region.
- Kikuchi-Fujimoto disease: A rare, self-limiting condition that causes lymphadenopathy, most commonly in the cervical region but can also involve the supraclavicular nodes.
- Sarcoidosis: Though it more commonly affects the hilar lymph nodes, sarcoidosis can occasionally cause supraclavicular lymphadenopathy.
- Kimura disease: A rare, chronic inflammatory disorder that can cause lymphadenopathy and eosinophilia, more commonly seen in Asian males.