[Enlarged lymph nodes as an incidental finding. How can carcinoma be excluded?].

Swollen lymph nodes are a very common pathological sign. The majority of cases met with at the primary care level are of an unspecific reactive nature. The first aim of the diagnostic evaluation is to exclude a malignant condition. Of decisive importance for any assessment of enlarged lymph nodes is the overall clinical presentation. History-taking should include data on age, course over time, general symptoms and occupation (contact with animals). The physical examination should aim to identify the distribution, size, consistency, tenderness, and site of the swellings. The diagnostic work-up is completed by laboratory investigations and imaging procedures. A stepped approach to the diagnostic evaluation is recommended.