Dr. Rosenberg Teaches the Lymph Node & Spleen Exam

March 27, 2014

Dr. Saul Rosenberg was first recruited to Stanford in 1961 and was involved in the creation of our hospital’s first lymphoma program. Today, Dr. Rosenberg shared his years of experience to lead our Stanford Medicine 25 session on the lymph node and spleen exam.

Take Home Point’s from Dr. Rosenberg:

* Benign lymph nodes are usually soft, flat, and oval and non-tender. Lymphadenopathy that is tender to palpation is usually inflammatory or infectious and not malignant.
* Abnormal nodes are rarely symmetrical in location, except for low-grade lymphoma’s and sometimes chronic lymphocytic lymphoma.
* Abnormal nodes are often spherical rather than oval and may be firm or hard.
* The axillae should be palpated with the patient in the sitting position and placing your hand far up into the apex which is uncomfortable and come down along the chest wall.
* The patient often is aware of your palpation of an abnormal lymph node because it flips over as you roll over it gently.
* The left supraclavicular fossa is the most important area to examine carefully because it is the lymphatic drainage site for abdominal malignancies via thoracic duct on the left side. This node is called the Virchow or sentinel node.
* Always wash your hands before and after examining the patient, keep your fingernails cut and your hands warm.

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